title: Risk factors for radiation pneumonitis caused by whole breast irradiation following breast-conserving surgery.
abstract: We evaluated risk factors of radiation pneumonitis (RP) after whole breast irradiation following breast-conserving surgery. Four hundred and seventy-two cases underwent whole breast irradiation with tangential field following breast-conserving surgery in our hospital, between January 2005 and April 2007. Of these cases, we performed statistical analyses for 423 breasts of 413 patients, using a pulmonary dose-volume histogram. Patient characteristics, treatment regimens and irradiation methods were included as variables in the analyses on risk factors of RP. As a result, 89 breasts of 84 cases (21%) were diagnosed with RP. The version 3.0 of the NCI Common Terminology Criteria for Adverse Events was used to evaluate the grade of pneumonitis: 77 cases (18.2%) were diagnosed as Grade 1 RP, 10 cases (2.3%) as Grade 2, and 2 cases (0.5%) as Grade 3. Multivariate analysis indicated that the significant risk factors for RP were central lung distance (CLD) (>1.8 cm) and the short axis length of the radiation field. The incidence of radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome significantly correlated only with CLD. The lung volume within the radiation field was shown to be a significant risk factor for RP and radiation-induced BOOP syndrome.
authors.affiliation: Department of Radiology, the University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kubo
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Osaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawanaka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Furutani
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikushima
authors.forename: Hiromu
authors.initials: H
authors.lastname: Nishitani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018549:Cryptogenic Organizing Pneumonia / Q000209:etiology; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology / Q000528:radiation effects; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D017564:Radiation Pneumonitis / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult