Is pectus excavatum a risk factor for radiation-induced lung disease in patients undergoing radiation therapy following breast-conserving surgery?


Journal

Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441

Informations de publication

Date de publication:
02 2019
Historique:
received: 13 10 2018
revised: 13 11 2018
accepted: 14 11 2018
pubmed: 19 12 2018
medline: 8 2 2020
entrez: 19 12 2018
Statut: ppublish

Résumé

The relationship between radiation dose to the ipsilateral lung and subsequent radiation-induced lung disease (RILD) in breast cancer patients with pectus excavatum (PE) undergoing radiation therapy (RT) to residual breast tissue after breast-conserving surgery has not yet been established. The incidence of RILD in such patients with PE, meaning that a large volume of the lung is within the radiation field, has not been determined. Therefore, the aim of this study was to determine the relationship between these factors. The study cohort comprised 133 women who underwent three-dimensional conformal RT to residual breast tissue after breast-conserving surgery for breast cancer. Diagnoses of PE were based on Haller's, frontosagittal, and Monden's depression indices. Radiation doses to the ipsilateral lung were established from dose-volume histograms. Fifty of the 133 participants (37.6%) were diagnosed with RILD; all were asymptomatic. Multivariate analysis revealed a significant correlation between the incidence of RILD and the administration of > 30 Gy (V30). Surprisingly, although patients with PE received higher ipsilateral lung doses, they were less likely to develop RILD than those without PE. Our data indicate that the incidence of RILD is correlated with the administration of > 30 Gy (V30) and that PE is not a risk factor for RILD after RT to residual breast tissue after breast-conserving surgery for breast cancer. Surprisingly, individuals with PE may have a lower incidence of RILD than those without this condition.

Sections du résumé

BACKGROUND
The relationship between radiation dose to the ipsilateral lung and subsequent radiation-induced lung disease (RILD) in breast cancer patients with pectus excavatum (PE) undergoing radiation therapy (RT) to residual breast tissue after breast-conserving surgery has not yet been established. The incidence of RILD in such patients with PE, meaning that a large volume of the lung is within the radiation field, has not been determined. Therefore, the aim of this study was to determine the relationship between these factors.
METHODS
The study cohort comprised 133 women who underwent three-dimensional conformal RT to residual breast tissue after breast-conserving surgery for breast cancer. Diagnoses of PE were based on Haller's, frontosagittal, and Monden's depression indices. Radiation doses to the ipsilateral lung were established from dose-volume histograms.
RESULTS
Fifty of the 133 participants (37.6%) were diagnosed with RILD; all were asymptomatic. Multivariate analysis revealed a significant correlation between the incidence of RILD and the administration of > 30 Gy (V30). Surprisingly, although patients with PE received higher ipsilateral lung doses, they were less likely to develop RILD than those without PE.
CONCLUSIONS
Our data indicate that the incidence of RILD is correlated with the administration of > 30 Gy (V30) and that PE is not a risk factor for RILD after RT to residual breast tissue after breast-conserving surgery for breast cancer. Surprisingly, individuals with PE may have a lower incidence of RILD than those without this condition.

Identifiants

pubmed: 30561105
doi: 10.1111/1759-7714.12933
pmc: PMC6360220
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

203-208

Informations de copyright

© 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

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Auteurs

Naoya Ishibashi (N)

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Toshiya Maebayashi (T)

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Takuya Aizawa (T)

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Masakuni Sakaguchi (M)

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Masaharu Hata (M)

Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.

Kenichi Sakurai (K)

Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.

Masahiro Okada (M)

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

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