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乳腺癌女性放疗后闭塞性细支气管炎并机化性肺炎的系统评价

Systematic review of postradiotherapy bronchiolitis obliterans organizing pneumonia in women with breast cancer.

作者信息

Epler Gary R, Kelly Eileen M

机构信息

Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Kelly Research and Consulting, Smithtown, New York, USA

Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Kelly Research and Consulting, Smithtown, New York, USA.

出版信息

Oncologist. 2014 Dec;19(12):1216-26. doi: 10.1634/theoncologist.2014-0041. Epub 2014 Oct 31.

Abstract

BACKGROUND

Radiation therapy for breast cancer has been implicated in the development of bronchiolitis obliterans organizing pneumonia (BOOP). This inflammatory lung disorder was first noted in 1983, and there have been numerous reports of BOOP occurring in women who have had radiation therapy for breast cancer since 1995. This study was undertaken to perform a systematic review of postradiotherapy BOOP to determine the occurrence, presentation, treatment, and outcome.

MATERIALS AND METHODS

A systematic literature review was conducted according to the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses report.

RESULTS

The literature search yielded 10 Japanese epidemiological reports with 129 women, 4 case series reports with 36 women, and 24 case reports with 34 women. Common symptoms included fever, cough, and shortness of breath. Most patients received corticosteroid therapy, and duration of treatment ranged from 6 months to 1 year, although some patients received steroids for longer than 1 year because of relapse, which occurred in approximately one half of patients. No deaths have been reported.

CONCLUSION

BOOP is a rare but significant complication from radiation therapy for breast cancer. Chest radiographic studies for women who report new respiratory symptoms during the postradiation period can be beneficial for early diagnosis and for guiding appropriate management.

摘要

背景

乳腺癌放射治疗与闭塞性细支气管炎伴机化性肺炎(BOOP)的发生有关。这种炎症性肺部疾病于1983年首次被发现,自1995年以来,已有大量关于接受乳腺癌放射治疗的女性发生BOOP的报道。本研究旨在对放疗后BOOP进行系统评价,以确定其发生率、表现、治疗及预后。

材料与方法

根据系统评价和Meta分析的首选报告项目(PRISMA)报告提供的指南进行系统文献检索。

结果

文献检索得到10篇日本流行病学报告,涉及129名女性;4篇病例系列报告,涉及36名女性;24篇病例报告,涉及34名女性。常见症状包括发热、咳嗽和气短。大多数患者接受了糖皮质激素治疗,治疗持续时间为6个月至1年,不过有些患者因复发而接受了超过1年的激素治疗,约一半的患者出现了复发。尚无死亡报告。

结论

BOOP是乳腺癌放射治疗罕见但严重的并发症。对放疗后出现新的呼吸道症状的女性进行胸部影像学检查,有助于早期诊断并指导适当的治疗。

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