Minor G Irene, Yashar Catheryn M, Spanos William J, Jose Baby O, Silverman Craig L, Carrascosa Luis A, Farmer Michael, Paris Kristie J
Central Indiana Cancer Center, Indianapolis, Indiana, and University of Louisville, Louisville Radiotherapy Associates, KY 40202, USA.
Breast J. 2006 Jan-Feb;12(1):48-52. doi: 10.1111/j.1075-122X.2006.00180.x.
Breast conservation therapy has become a common modality for therapy of early stage breast cancer. Most studies of primary lung irradiation correlate the risk of pneumonitis with the volume of lung treated. It is proposed that the lung volume treated during tangential radiation of the intact breast may be calculated from a measurement of the central lung distance. Central lung distance is the distance from the chest wall to the edge of the field at the central axis. This study examines whether the incidence of radiation pneumonitis indeed correlates with the lung volume treated as calculated from a measurement of the central lung distance. From January 1, 1985, through December 31, 1998, 353 patients were treated with breast conservation therapy at the University of Louisville. The charts were reviewed for any evidence of clinically significant radiation pneumonitis. The treatment films were obtained and the central lung distance ascertained. Four cases of radiation pneumonitis were identified. Three of these occurred after tangential radiation and one occurred in a retreatment field after bone marrow transplant. The overall rate of radiation pneumonitis was 1.2%. A central lung distance of less than 3 cm was found in 78.3% of patients and 21.7% had a central lung distance of three or greater. There was no correlation between central lung distance and the risk of radiation pneumonitis. Breast conservation therapy is a well-tolerated modality for treatment of early stage breast cancer. The incidence of radiation pneumonitis is very low and is usually associated with other factors in addition to the tangential field lung volume.
保乳治疗已成为早期乳腺癌治疗的一种常见方式。大多数关于原发性肺部放疗的研究将肺炎风险与受照射的肺体积相关联。有人提出，完整乳房切线照射期间受照射的肺体积可通过测量中心肺距离来计算。中心肺距离是从胸壁到中心轴处野边缘的距离。本研究旨在探讨放射性肺炎的发生率是否确实与通过测量中心肺距离计算出的受照射肺体积相关。从1985年1月1日至1998年12月31日，路易斯维尔大学有353例患者接受了保乳治疗。对病历进行了审查，以寻找任何具有临床意义的放射性肺炎证据。获取了治疗胶片并确定了中心肺距离。发现4例放射性肺炎。其中3例发生在切线照射后，1例发生在骨髓移植后的再治疗野中。放射性肺炎的总体发生率为1.2%。78.3%的患者中心肺距离小于3 cm，21.7%的患者中心肺距离为3 cm或更大。中心肺距离与放射性肺炎风险之间无相关性。保乳治疗是早期乳腺癌治疗中耐受性良好的一种方式。放射性肺炎的发生率非常低，通常除了切线野肺体积外还与其他因素有关。
