Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
McMaster University, Hamilton, Ontario, Canada.
J Med Imaging Radiat Sci. 2023 Jun;54(2):281-290. doi: 10.1016/j.jmir.2023.01.008. Epub 2023 Feb 15.
As breast cancer radiotherapy (RT) has been shown to give rise to adverse pulmonary outcomes, such as radiation pneumonitis, trends in patient-reported shortness of breath (SOB) associated with RT were investigated. Adjuvant RT is commonly administered for local and/or regional control of breast cancer and was therefore included.
The Edmonton Symptom Assessment System (ESAS) was used to observe changes in SOB during RT, up to 6 weeks after RT completion, and one to three months post-RT. Patients with at least one completed ESAS were included in the analysis. Generalized linear regression analysis was performed to identify associations between demographic factors and SOB.
A total of 781 patients were included in the analysis. There was a significant association between ESAS SOB scores and adjuvant chemotherapy when compared to neoadjuvant chemotherapy (p=0.0012). Meanwhile, loco-regional RT had no significant impact on ESAS SOB scores in comparison to local RT. SOB scores were stable over time (p>0.05) from baseline to follow-up appointments.
The findings of this study suggest that RT was not associated with changes in SOB from baseline to 3 months post-RT. However, patients who underwent adjuvant chemotherapy reported significant higher SOB scores over time. Additional research is recommended to analyze the lasting effects of adjuvant breast cancer RT on SOB during physical activity.
乳腺癌放疗（RT）可引起不良的肺部并发症，如放射性肺炎。因此，本研究旨在调查与 RT 相关的患者报告的呼吸困难（SOB）的变化趋势。辅助 RT 常用于控制乳腺癌的局部和/或区域复发，因此也包括在内。
采用埃德蒙顿症状评估系统（ESAS）观察 RT 期间、RT 完成后 6 周内以及 RT 后 1-3 个月期间 SOB 的变化。至少有一份完整 ESAS 评分的患者被纳入分析。采用广义线性回归分析来确定人口统计学因素与 SOB 之间的关联。
共纳入 781 例患者进行分析。与新辅助化疗相比，辅助化疗与 ESAS SOB 评分显著相关（p=0.0012）。同时，与局部 RT 相比，局部区域 RT 对 ESAS SOB 评分没有显著影响。SOB 评分从基线到随访期间保持稳定（p>0.05）。
本研究结果表明，从基线到 RT 后 3 个月，RT 与 SOB 无变化相关。然而，接受辅助化疗的患者报告的 SOB 评分随时间显著升高。建议进行更多的研究来分析辅助乳腺癌 RT 对体力活动期间 SOB 的持久影响。
