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Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study

Title
Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study
Authors
Choi, JinhyunKim, Yong BaeShin, Kyung HwanAhn, Sung-JaLee, Hyung-SikPark, WonKim, Su SsanKim, Jin HeeLee, Kyu ChanKim, Dong WonSuh, Hyun SukPark, Kyung RanShin, Hyun SooSuh, Chang-Ok
Ewha Authors
서현숙
Issue Date
2016
Journal Title
JOURNAL OF BREAST CANCER
ISSN
1738-6756JCR Link2092-9900JCR Link
Citation
vol. 19, no. 3, pp. 275 - 282
Keywords
Breast neoplasmsLymphatic irradiationRadiation pneumonitis
Publisher
KOREAN BREAST CANCER SOC
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: The aim of this study is to present the incidence of radiation pneumonitis (RP) reported within 6 months after treatment for breast cancer with or without internal mammary node irradiation (IMNI). Methods: In the Korean Radiation Oncology Group (KROG) 08-06 phase III randomized trial, patients who were node-positive after surgery were randomly assigned to receive radiotherapy either with or without IMNI. A total of 747 patients were enrolled, and three:dimensional treatment planning with computed tomography simulation was performed for all patients. Of the 747 patients, 722 underwent chest X-rays before and within 6 months after radiotherapy. These 722 patients underwent evaluation, and RP was diagnosed on the basis of chest radiography findings and clinical symptoms. The relationship between the incidence of RP and clinical/dosimetric parameters was analyzed. Results: RP developed in 35 patients (4.8%), including grade 1 RP in 26 patients (3.6%), grade 2 RP in nine patients (1.2%); there was no incidence of grade 3 or higher RP Grade 2 RP cases were observed in only the IMNI group. The risk of developing RP was influenced by IMNI treatment; pneumonitis occurred in 6.5% of patients (n=23/356) who underwent IMNI and in 3.3% of patients (n=12/366) who did not (p= 0.047). The differences in lung dosimetric parameters (mean lung dose, V10-40) were statistically significant between the two groups. Conclusion: IMNI treatment resulted in increased radiation exposure to the lung and a higher rate of RP, but the incidence and severity of RP was minimal and acceptable. This minor impact on morbidity should be balanced with the impact on survival outcome in future analyses.
DOI
10.4048/jbc.2016.19.3.275
Appears in Collections:
의과대학 > 의학과 > Journal papers
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