The role of systemic therapies in the development of lung sequelae after conformal radiotherapy in breast cancer patients.

Abstract #4125

Some data suggest that adjuvant systemic therapies like tamoxifen and paclitaxel play a role in the development of radiogenic lung toxicity.
 Early and late radiogenic lung sequelae were prospectively studied in patients receiving sequential taxane-based chemotherapy (Tax), concomittant hormone therapy with tamoxifen (Tam) or aromatase inhibitor (AI), or no systemic therapy (C) according to the institutional guidelines. Clinical signs, radiologic abnormalities and the mean lung density changes measured at the level of the left heart ventricle (MDC_LHV) and the head of the clavicle (MDC_HC) of the irradiated lung on CT were evaluated according to Kahan et al., Int. J. Radiat. Oncol. Biol. Phys., 2007.
 The incidence of pneumonitis grade I with or without clinical symptoms did not significantly differ between the 4 groups. None of the patients developed symptomatic radiogenic lung fibrosis one year after the radiotherapy, however, radiogenic CT changes were significantly more frequent in the group treated with Tam. No differences in the MDC_LHV and MDC_HC values according to systemic therapy were detected 3 months or 1 year after the radiotherapy (Table). Significant positive associations existed between radiogenic lung changes with or without clinical symptoms and the age of the patient, the ipsilateral mean lung dose (MLD), the volume of the ipsilateral lung receiving ≥20 Gy (V_{20 Gy}) and the irradiation of the axillary and supraclavicular lymph nodes. Extended data and statistical analysis including multiple linear regression and multivariate logistic regression models will be presented.


Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4125.