Purpose: To study the early and late pulmonary complications of radiotherapy (RT) in patients with operated breast cancer who received postoperative RT.
Patients and methods: Radiation pneumonia (RP) and radiation fibrosis (RF) rates were evaluated after 3 and 18 months from the end of RT, using the Radiation Therapy Oncology Group and the European Organization for the Research and Treatment of Cancer (RTOG/ EORTC) combined toxicity classification scale. Evaluation included physical examination, high resolution computed tomography (HRCT) of the thorax, and pulmonary function tests (PFTs). The incidence of RP and RF, the relationship between RP and RF and possible predisposing factors and the impact of RT on the PFTs were analyzed.
Results: Between December 2000 and March 2001 35 patients were included in the study. Due to several reasons 29 patients were evaluable for RP and 25 for RF. On the 3rd month post-RT, 17 (59%) patients developed RP. Three (18%) of the cases were grade 1, 13 (76%) grade 2 and 1 (6%) grade 3. One patient was radiologically diagnosed with early RF. When evaluated for RF, 9 (36%) of 25 patients were found to have RF. Four (45%) of them were grade 1, and 5 (55%) grade 2. FEV1, FEV1/FVC, VC, FVC values showed different degrees of decline on the 3rd month. The most prominent change occurred with DLCO/ VA ratio which decreased by 20%. On the 18th month, all values returned to at least the pretreatment levels.
Conclusion: RT-induced RP and RF are quite frequent. As clinical findings are generally nonspesific, radiological findings of RP and RF should be known. Early and late effects on PFTs are generally mild and transient.