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KMID : 0390320080180020400
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Chungbuk Medical Journal
2008 Volume.18 No. 2 p.400 ~ p.407
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Acute Pulmonary Complications after Conformal Radiotherapy of Breast Cancer
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Kim Won-Dong
Park Yoon-Woo
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Abstract
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Purpose : This study was intended to evaluate incidence and risk factors of acute pulmonanry complications in early stage breast cancer patients, who were treated by conservative surgery and postoperative 3-D conformal radiotherapy.
Materials and Methods : Thirty patients were enrolled and were treated by 6 MV irradiation using a half beam tangential technique. We observed acute pulmonary complications at 1 week interval during radiotherapy using common toxicity criteria version 2.0 and peak grade was recorded. Parameters relevant to acute pulmonanry complications included; 1) MaxLD (maximum lung dose), MedLD (median lung dose), MeanLD (mean lung dose), V20Gy and D25% on dose-volume histogram (DVH), 2) CLD (central lung distance) and MLD (maximum lung distance) on simlation film, 3) GPLD (greatest perpendicular lung distance) on central level CT image. Their association with acute pulmonanry complications were investigated using univariate T-test analysis.
Results : Twenty five patients (83%) had a grade of 0 (no change) and grade 1 occurred in 5 patients (17%). No patients experienced grade 2, 3 and 4 acute pulmonary complications. The mean MaxLD, MedLD, MeanLD, V20Gy, D25%,, CLD, MLD and GPLD were 51.80 Gy (20.2-56.0 Gy), 1.60 Gy (0.8-2.2 Gy), 4.38 Gy (1.4-7.3 Gy), 5.20% (0.02-11.9%), 3.03 Gy (1.8-3.9 Gy), 1.17 cm (0.3-2.0 cm), 1.47 cm (0.5-2.5 cm) and 1.21 cm (0.3-2.2 cm), respectively. On univariate t-test analysis, MeanLD, V20Gy and CLD were significantly associated with acute pulmonanry complications (p<0.05).
Conclusion : Our treatment technique adequately met lung (organ at risk) dose constraints guideline such as MeanLD<20 Gy, V20Gy<25% and CLD<3 cm. Only grade 1 acute pulmonary complication occurred in 17% of patients who had a larger mean value of MeanLD, V20Gy and CLD compared with no complication group but it did not need a prescription and prolong the overall radiotherapy time.
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KEYWORD
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Breast cancer, Conformal radiotherapy and Acute pulmonary complications
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