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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
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, patie...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Breast Cancer Society
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053312/ https://www.ncbi.nlm.nih.gov/pubmed/27721877 http://dx.doi.org/10.4048/jbc.2016.19.3.275 |
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author | Choi, Jinhyun Kim, Yong Bae Shin, Kyung Hwan Ahn, Sung-Ja Lee, Hyung-Sik Park, Won Kim, Su Ssan Kim, Jin Hee Lee, Kyu Chan Kim, Dong Won Suh, Hyun Suk Park, Kyung Ran Shin, Hyun Soo Suh, Chang-Ok |
author_facet | Choi, Jinhyun Kim, Yong Bae Shin, Kyung Hwan Ahn, Sung-Ja Lee, Hyung-Sik Park, Won Kim, Su Ssan Kim, Jin Hee Lee, Kyu Chan Kim, Dong Won Suh, Hyun Suk Park, Kyung Ran Shin, Hyun Soo Suh, Chang-Ok |
author_sort | Choi, Jinhyun |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5053312 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Breast Cancer Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-50533122016-10-07 Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study Choi, Jinhyun Kim, Yong Bae Shin, Kyung Hwan Ahn, Sung-Ja Lee, Hyung-Sik Park, Won Kim, Su Ssan Kim, Jin Hee Lee, Kyu Chan Kim, Dong Won Suh, Hyun Suk Park, Kyung Ran Shin, Hyun Soo Suh, Chang-Ok J Breast Cancer Original Article 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. Korean Breast Cancer Society 2016-09 2016-09-23 /pmc/articles/PMC5053312/ /pubmed/27721877 http://dx.doi.org/10.4048/jbc.2016.19.3.275 Text en © 2016 Korean Breast Cancer Society. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Choi, Jinhyun Kim, Yong Bae Shin, Kyung Hwan Ahn, Sung-Ja Lee, Hyung-Sik Park, Won Kim, Su Ssan Kim, Jin Hee Lee, Kyu Chan Kim, Dong Won Suh, Hyun Suk Park, Kyung Ran Shin, Hyun Soo Suh, Chang-Ok 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 |
title_full | Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study |
title_fullStr | Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study |
title_full_unstemmed | Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study |
title_short | Radiation Pneumonitis in Association with Internal Mammary Node Irradiation in Breast Cancer Patients: An Ancillary Result from the KROG 08-06 Study |
title_sort | radiation pneumonitis in association with internal mammary node irradiation in breast cancer patients: an ancillary result from the krog 08-06 study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053312/ https://www.ncbi.nlm.nih.gov/pubmed/27721877 http://dx.doi.org/10.4048/jbc.2016.19.3.275 |
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