AlSaeed Eyad Fawzi, Balaraj Faisal Khalid, Tunio Mutahir A
Department of Radiation Oncology, Faculty of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
Al Faisal University, Chair of Radiation Oncology, Tawam Hospital, Al Ain, United Arab Emirates.
Breast Cancer (Dove Med Press). 2017 May 29;9:375-381. doi: 10.2147/BCTT.S114575. eCollection 2017.
The aim of present pilot study was to evaluate the changes in pulmonary function tests (PFTs) after locoregional post-mastectomy radiotherapy (PMRT) in breast cancer patients.
Twenty consecutive patients with histopathologically confirmed breast carcinoma stages T1-T4, N1-N2, who were treated with modified radical mastectomy with neoadjuvant or adjuvant chemotherapy underwent PFTs, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV), forced expiratory flow at 50%, and peak expiratory flow rate, maximum mid expiratory flow (MMEF), maximal oxygen consumption (VOmax), and carbon monoxide diffusing capacity (DLCO) before, at 30 days, and at 90 days after locoregional PMRT. A two-tailed paired Student's -test was used to compare mean values among the variables between the groups.
A significant drop in FVC, FEV, and DLCO was noticed at day 90 after the completion of locoregional PMRT with -values 0.033, 0.042, and 0.031, respectively, while MMEF and VOmax were not significantly affected (-values 0.075 and 0.062, respectively) favoring a restrictive lung injury pattern. However, no patient was found to be symptomatic.
A significant drop in reduction in PFTs occurred at day 90 after the completion of locoregional PMRT. PFTs shall be performed in all breast cancer patients receiving locoregional PMRT for early detection of radiation-induced lung toxicity as all patients in our cohort were found asymptomatic.
本初步研究的目的是评估乳腺癌患者局部区域乳房切除术后放疗(PMRT)后肺功能测试(PFTs)的变化。
连续20例经组织病理学确诊为T1 - T4期、N1 - N2期乳腺癌患者,接受了新辅助或辅助化疗的改良根治性乳房切除术,并在局部区域PMRT前、术后30天和90天进行了肺功能测试,包括用力肺活量(FVC)、第1秒用力呼气量(FEV)、50%用力呼气流量、呼气峰值流速、最大呼气中期流速(MMEF)、最大耗氧量(VOmax)和一氧化碳弥散量(DLCO)。采用双尾配对t检验比较两组变量之间的平均值。
局部区域PMRT完成后90天,FVC、FEV和DLCO显著下降,p值分别为0.033、0.042和0.031,而MMEF和VOmax未受到显著影响(p值分别为0.075和0.062),呈现限制性肺损伤模式。然而,未发现有患者出现症状。
局部区域PMRT完成后90天,肺功能测试出现显著下降。所有接受局部区域PMRT的乳腺癌患者均应进行肺功能测试,以便早期发现放射性肺毒性,因为我们队列中的所有患者均无症状。