Ooi G C, Kwong D L, Chan K N, Ngan H, Lock D T, Lam W K, Chan F L, Au G, Tsang K W
Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong SAR, China.
Clin Radiol. 2000 Nov;55(11):817-24. doi: 10.1053/crad.2000.0542.
To document serial high resolution computed tomography (HRCT) features of lung injury after 3-field radiotherapy for breast cancer.
Thirty women who received opposing tangential chest wall and supraclavicular field (SCF) irradiation after breast surgery were recruited. Thoracic HRCT was performed before and at 1, 3, 6 and 12 months after radiotherapy (RT). Lung injury at 3 months was quantified by applying a scoring system to each HRCT section. Findings were correlated with spirometric lung function tests.
There was HRCT evidence of lung injury in 27 (90%) women at 1 month and in all 30 patients at 3 months. Spirometric lung function declined post-RT (P < 0.05), correlating with an increased SCF acute lung injury score at 3 months [r = -0.54 and -0.46, P = 0.01 and 0.03 for forced expiratory volume in 1st (FEV(1)) and forced vital capacity (FVC), respectively]. Lung injury on HRCT progressed from ground glass opacification at 1 month to nodular consolidation (3 months), increasing linear densities (6 months), and finally to residual subpleural linear and dense opacities (12 months).
There is a high incidence of lung injury associated with 3-field radiotherapy for breast cancer, with concurrent SCF irradiation increasing the risk of lung damage and functional impairment. A characteristic sequence of HRCT changes is seen in most patients receiving this type of radiotherapy.Ooi, G. C. (2000). Clinical Radiology55, 817-824.
记录乳腺癌三野放疗后肺损伤的系列高分辨率计算机断层扫描（HRCT）特征。
招募30名乳腺癌手术后接受对侧切线胸壁和锁骨上野（SCF）照射的女性。在放疗（RT）前以及放疗后1、3、6和12个月进行胸部HRCT检查。通过对每个HRCT切片应用评分系统来量化3个月时的肺损伤。研究结果与肺功能肺活量测定试验相关。
27名（90%）女性在1个月时HRCT有肺损伤证据，所有30名患者在3个月时均有肺损伤。放疗后肺功能肺活量测定值下降（P < 0.05），与3个月时SCF急性肺损伤评分增加相关[r = -0.54和-0.46，第1秒用力呼气量（FEV(1)）和用力肺活量（FVC）的P值分别为0.01和0.03]。HRCT上的肺损伤从1个月时的磨玻璃样混浊发展为结节状实变（3个月）、线状密度增加（6个月），最终发展为残留的胸膜下线状和致密混浊（12个月）。
乳腺癌三野放疗相关的肺损伤发生率很高，同时进行SCF照射会增加肺损伤和功能损害的风险。在接受这种放疗的大多数患者中可观察到HRCT变化的特征性序列。Ooi, G. C.（2000年）。《临床放射学》55，817 - 824。
