title: Analysis of predictive factors for lung injury after forward-planned intensity-modulated radiotherapy in whole breast irradiation.
abstract: OBJECTIVE
  This study was performed to assess frequency, timings of occurrence, and predictors of radiologic lung damage (RLD) after forward-planned intensity-modulated radiotherapy (FIMRT) for whole breast irradiation.
  
  
  METHODS
  We retrospectively reviewed medical records of 157 breast cancer patients and each of their serial chest computed tomography (CT) taken 4, 10, 16, and 22 months after completion of breast radiotherapy (RT). FIMRT was administered to whole breast only (n=152), or whole breast and supraclavicular regions (n=5). Dosimetric parameters, such as mean lung dose and lung volume receiving more than 10 to 50 Gy (V10-V50), and clinical parameters were analyzed in relation to radiologic lung damage.
  
  
  RESULTS
  In total, 104 patients (66.2%) developed RLD after whole breast FIMRT. Among the cases of RLD, 84.7% were detected at 4 months, and 15.3% at 10 months after completion of RT. More patients of 47 or younger were found to have RLD at 10 months after RT than patients older than the age (11.7% vs. 2.9%, p=0.01). In univariate and multivariate analyses, age >47 and V40 >7.2% were significant predictors for higher risk of RLD.
  
  
  CONCLUSIONS
  RLD were not infrequently detected in follow-up CT after whole breast FIMRT. More detected cases of RLD among younger patients are believed to have developed at later points after RT than those of older patients. Age and V40 were significant predictors for RLD after whole breast intensity-modulated radiotherapy.
authors.affiliation: Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Haeyoung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Hoonsik
authors.initials: H
authors.lastname: Bae
authors.affiliation: Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Me-Yeon
authors.initials: MY
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Kwang-Ho
authors.initials: KH
authors.lastname: Cheong
authors.affiliation: Department of Radiation Oncology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Kyoung Ju
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Taejin
authors.initials: T
authors.lastname: Han
authors.affiliation: Department of Radiation Oncology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Sei-Kwon
authors.initials: SK
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Soah
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Taejin
authors.initials: T
authors.lastname: Hwang
authors.affiliation: Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Jai-Woong
authors.initials: JW
authors.lastname: Yoon
authors.affiliation: Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Lee Su
authors.initials: LS
authors.lastname: Kim
keywords: Breast neoplasms; Intensity-modulated radiotherapy; Lung injury
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