Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, South Korea.
Department of Radiology, Ewha Womans University College of Medicine, Seoul, South Korea.
Br J Radiol. 2021 Aug 1;94(1124):20200997. doi: 10.1259/bjr.20200997. Epub 2021 Jun 16.
To evaluate the CT findings of acute radiation pneumonitis (RP) in breast cancer patients undergoing post-operative radiotherapy, and to analyze clinicodosimetric factors associated with acute RP.
Between 2015 and 2017, 61 patients with breast cancer who underwent follow-up chest CT at 3 months after radiotherapy were analyzed. The degree of acute RP on CT was evaluated by the change of extent and scoring system (grade 0, no RP; Grade 1, ground-glass opacities (GGOs); Grade 2, GGOs and/or consolidations; Grade 3, clear focal consolidation; Grade 4, dense consolidation). The dosimetric parameters were calculated from the dose-volume histogram of RT.
The acute RP on CT was scored as follows: Grade 0, in 37.7%, Grade 1 in 13.1%, Grade 2 in 44.3%, and Grade 3 in 4.9%. The median extent of RP in patients with Grades 1 to 3 was 6.2 ml (range, 0.2-95.9). There were no clinicodosimetric factors significantly associated with the presence of RP or its severity. One patient developed symptomatic RP.
This study showed no correlation between acute RP and clinicodosimetric factors, and acute RP based on CT findings were much more common than symptomatic RP.
CT findings of acute RP or extent of RP were not significantly related to clinicodosimetric factors in breast cancer patients.
评估乳腺癌术后放疗后急性放射性肺炎(RP)的 CT 表现,并分析与急性 RP 相关的临床剂量学因素。
对 2015 年至 2017 年间 61 例乳腺癌患者在放疗后 3 个月行胸部 CT 随访的资料进行分析。采用病变范围和评分系统(0 级,无 RP;1 级,磨玻璃影(GGOs);2 级,GGOs 合并/不合并实变;3 级,斑片状实变;4 级,致密实变)评估 CT 上急性 RP 的程度。从 RT 的剂量-体积直方图中计算剂量学参数。
CT 上急性 RP 评分如下:0 级占 37.7%,1 级占 13.1%,2 级占 44.3%,3 级占 4.9%。1 至 3 级患者的 RP 病变程度中位数为 6.2ml(范围:0.2-95.9)。无临床剂量学因素与 RP 的发生或严重程度显著相关。1 例患者出现症状性 RP。
本研究显示急性 RP 与临床剂量学因素之间无相关性,且 CT 发现的急性 RP 比有症状性 RP 更为常见。
乳腺癌患者急性 RP 的 CT 表现或 RP 程度与临床剂量学因素无显著相关性。