Ooi G C, Kwong D L, Ho J C, Lock D T, Chan F L, Lam W K, Ngan H, Au G, Tsang K W
Department of Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital, SAR, China.
Int J Radiat Oncol Biol Phys. 2001 Jun 1;50(2):411-9. doi: 10.1016/s0360-3016(01)01438-9.
To prospectively study the effects of loco-regional radiotherapy in women with breast cancer.
Thirty consecutive patients with breast resection underwent clinical, lung function, radiographic, and thoracic high-resolution computed tomography evaluation before and at 1, 3, 6, and 12 months after adjuvant radiotherapy. Chemotherapy was also administered to 15 patients.
Nineteen patients reported mild respiratory symptoms at 1 month, which resolved completely at 6 months after radiotherapy. Opacities were present on 80% of chest radiographs and in all patients on high-resolution computed tomography by 3 months. These opacities became compact and persisted on high-resolution computed tomography at 12 months. Lung function indices, including FEV1, FVC, TLC, and DLCO, progressively declined after radiotherapy, and was irreversible at 12 months (p < 0.05). Patients who received chemotherapy did not have significantly different lung function indices compared with their counterparts at all time points (p > 0.05).
Our results have shown that adjuvant loco-regional radiotherapy, a common practice in breast cancer treatment, is associated with irreversible reduction in lung function parameters. These changes are accompanied by radiological evidence of persistent lung injury. Further studies should be performed to evaluate the incidence and long-term pulmonary sequelae of current treatment for breast cancer.
前瞻性研究局部区域放疗对乳腺癌女性患者的影响。
连续30例接受乳房切除术的患者在辅助放疗前以及放疗后1、3、6和12个月接受了临床、肺功能、影像学和胸部高分辨率计算机断层扫描评估。15例患者还接受了化疗。
19例患者在放疗后1个月出现轻度呼吸道症状，在放疗后6个月完全缓解。3个月时，80%的胸部X光片出现肺部阴影，所有患者的高分辨率计算机断层扫描均显示有阴影。这些阴影在12个月时变得致密，并在高分辨率计算机断层扫描上持续存在。包括第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、肺总量（TLC）和一氧化碳弥散量（DLCO）在内的肺功能指标在放疗后逐渐下降，在12个月时不可逆转（p<0.05）。接受化疗的患者在所有时间点的肺功能指标与未接受化疗的患者相比无显著差异（p>0.05）。
我们的结果表明，辅助局部区域放疗作为乳腺癌治疗的一种常见做法，与肺功能参数的不可逆降低有关。这些变化伴随着持续性肺损伤的影像学证据。应进一步开展研究，以评估当前乳腺癌治疗方法的发生率和长期肺部后遗症。
