title: Long-term functional and radiological pulmonary changes after radiation therapy for breast cancer.
abstract: BACKGROUND
  We assessed late functional and radiological pulmonary changes in breast cancer patients after a median of 11 years following radiotherapy (RT).
  
  
  METHODS
  Seventy women who received adjuvant loco-regional RT for breast cancer during November 1994-May 1998 accepted to participate in this follow-up study. Pulmonary function tests (PFTs) (n = 56) were compared to pre-RT examinations and diagnostic computer tomography (CT) of the lungs (n = 70) were performed and compared to four months post-RT examinations.
  
  
  RESULTS
  The median-matched vital capacity (VC), forced expiratory volume in one second (FEV1), and total lung capacity (TLC) were reduced 15%, 9%, and 7%, respectively, at the long-term follow-up (p < 0.001). We could not, however, detect a correlation between ipsilateral V20 and VC-changes. Diffusion capacity (DLCO) appeared to improve compared with the pre-RT baseline level probably due to transient chemotherapy-induced toxicity. The median-matched percentage of the predicted DLCO 11 years after RT was, however, only 86%, indicating a chronic therapy-induced reduction also of this metric. According to the Arriagada classification, ipsilateral V20 and long-term CT-changes showed a significant correlation (rs: 0. 57; p < 0.001) in a small subset of the women.
  
  
  CONCLUSIONS
  A chronic clinically significant reduction of PFTs compared to pre-RT values and CT-changes four months after RT were still detectable after a median follow-up of 11 years. There was a statistical correlation between V20 and abnormalities on CT but no statistical correlation between V20 and VC-changes.
authors.affiliation: Department of Oncology, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Blom Goldman
authors.forename: Gunilla
authors.initials: G
authors.lastname: Svane
authors.forename: Martin
authors.initials: M
authors.lastname: Anderson
authors.forename: Berit
authors.initials: B
authors.lastname: Wennberg
authors.forename: Pehr
authors.initials: P
authors.lastname: Lind
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology / Q000528:radiation effects; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000502:physiology / Q000528:radiation effects*; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D058958:Organs at Risk / Q000000981:diagnostic imaging / Q000502:physiology / Q000528:radiation effects*; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity / Q000502:physiology / Q000528:radiation effects; D014797:Vital Capacity / Q000502:physiology / Q000528:radiation effects