Radiological and functional assessment of radiation-induced pulmonary damage following breast irradiation.
OBJECTIVE
The purpose of this study was to compare late radiation-induced radiological abnormalities of the lung with spirometric observations. Radiological abnormalities were also related to theoretical calculations, in order to predict late effects based on dose-volume histograms.


METHODS
Sixty-one breast cancer patients who had received postoperative radiotherapy were included. During a follow-up examination 3 years or more after start of radiotherapy, computed tomography (CT) scans and pulmonary function tests were performed. Grading of radiological abnormalities (fibrosis) was performed based on CT images. Based on the dose volume histograms of the lung, effective dose was calculated.


RESULTS
There was a positive correlation between the effective radiation dose and the fraction of patients that developed radiation induced fibrosis. No significant association was found between the normalized forced vital capacity (FVC) and the radiological abnormality score or the effective radiation dose.


CONCLUSIONS
In this study we found no correlation between local radiation-induced changes in the lung tissue and overall lung function. The effective dose was a better predictive factor for radiation induced fibrosis than for overall lung function.
Vågane
Randi
R
Institute for Cancer Research, The Norwegian Radium Hospital, Rikshospitalet, Montebello, Oslo, Norway.
Bruland
Øyvind S
ØS
Fosså
Sophie D
SD
Olsen
Dag R
DR
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000528:radiation effects; D008875:Middle Aged; D011446:Prospective Studies; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013147:Spirometry; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity