A Review of Treatment-Induced Pulmonary Toxicity in Breast Cancer

Mo, Hanjie; Jazieh, Khalid; Brinzevich, Daria; Abraham, Jame

doi:10.1016/j.clbc.2021.05.014

Cited by 11 publications

(6 citation statements)

References 97 publications

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“…Radiation pneumonia, dermatitis, and cardiovascular injury are important treatment-related toxicities, particularly in the chemotherapy, target therapy, and RT settings [14][15][16][17][18]. However, most of these data were from CFRT or HFRT trials.…”

Section: Discussionmentioning

confidence: 99%

Whole breast ultrafractionation radiotherapy after breast‐conserving surgery in early breast cancer: A single‐center, prospective, observational study from China

Zhao,

Huang,

Tang

et al. 2024

Malignancy Spectrum

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ObjectiveThis single‐center, prospective, observational study was designed to investigate the toxicities, patient‐reported outcome (PRO), and dosimetric analysis of whole breast ultrafractionation radiotherapy (RT) after breast‐conserving surgery (BCS) in early breast cancer (BC).Patients and methodsPatients diagnosed with BC stage I, II and treated with BCS were enrolled. A dose of 26 Gray (Gy) in five fractions was prescribed to the whole breast and tumor bed. Clinical endpoints included toxicities, PRO, and dosimetric analysis. PRO was measured by the European Organization for Research and Treatment of Cancer general quality of life questionnaire (EORTC QLQ‐C30) and the BC‐specific questionnaire (EORTC QLQ‐BR23) questionnaires.ResultsBetween January 2022 and June 2023, 62 female patients were enrolled. The median age was 45 years. Most patients (83.9%) were diagnosed with pathological stage I disease. The median planning target volume (PTV) was 456.4 mL. The minimum, maximum, and mean doses, and D95 (dose of PTV irradiated volume more than 95%) to PTV were 20.2, 28.8, 27.2, and 26.3 Gy, respectively. The median mean lung dose and percentage lung volume receiving 8 Gy (V8) were 3.6 Gy and 13.4%, respectively. The median mean heart dose, V1.5 (percentage of organ volume irradiated with 1.5 Gy or higher), and V7 (percentage of organ volume irradiated with 7 Gy or higher) were 0.6 Gy, 6.8%, and 0.4%, respectively. Cosmetic effects before RT showed no obvious differences compared to that post RT. No toxicities of grade 3 or higher occurred. Five patients had asymptomatic radiation pneumonia (grade 1), and 12 patients had radiation dermatitis (grade 1). No factor was significantly related to radiation dermatitis or radiation pneumonia. For the EORTC QLQ‐C30 and QLQ‐BR23 questionnaires, all function and symptom scores before RT had no significant differences compared with that after RT, 1−2 months after RT, and 3−4 months after RT. Ultrafractionation RT did not worsen PRO. The 1‐year crude local control was 100%.ConclusionWhole breast ultrafractionation RT after BCS in early BC has no severe toxicities and does not affect PRO. These results need to be further validated with a longer follow‐up and a larger sample size.

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Section: Discussionmentioning

confidence: 99%

Whole breast ultrafractionation radiotherapy after breast‐conserving surgery in early breast cancer: A single‐center, prospective, observational study from China

Zhao,

Huang,

Tang

et al. 2024

Malignancy Spectrum

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“…First, normal cardiac performance values combined with the absence of features of cardiac failure make pulmonary edema less likely to be a contributing factor. Secondly, given the timing of the last chemotherapy and the similarity of symptoms and chest CT findings to drug-induced pneumonitis in this case, it is difficult to completely rule out the contribution of drug toxicity caused by paclitaxel [ 22 ]. Unfortunately, no diagnostic test can adjudicate drug-induced pneumonitis, as it is indeed a diagnosis of exclusion [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, given the timing of the last chemotherapy and the similarity of symptoms and chest CT findings to drug-induced pneumonitis in this case, it is difficult to completely rule out the contribution of drug toxicity caused by paclitaxel [ 22 ]. Unfortunately, no diagnostic test can adjudicate drug-induced pneumonitis, as it is indeed a diagnosis of exclusion [ 22 , 23 ]. However, there was ample evidence that this patient had known immunosuppression predisposing to a severe course of EBV infection.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr virus (EBV) induced pneumonitis in a patient with breast cancer receiving neoadjuvant chemotherapy: A case report

Liao¹,

Zhu²,

Cheng³

2023

Respiratory Medicine Case Reports

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“…Breast cancer surgery may also lead to 'phantom breast pain' and shoulder problems (56). Adjuvant radiotherapy is associated with several side effects, including pneumonitis months after treatment and late lung fibrosis in the radiotherapy field (57). Late cardiac side effects have been reported, resulting in an increased risk of cardiac mortality for as long as 25 years after treatment, especially for younger women and those treated with chemotherapy (58).…”

Section: Side Effects Of Early-stage Breast Cancer Treatmentmentioning

confidence: 99%

Taxane-Induced Peripheral Neuropathy among Early-Stage Breast Cancer Survivors : Prevalence, Risk Factors, Quality of Life and Genetic Prediction Models

Engvall

2024

Linköping University Medical Dissertations

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Background: Taxane-induced peripheral neuropathy (TIPN) is a common and distressful side effect. Little is known on how long TIPN persist and its effect on health-related quality of life (HRQL). The overall aim of this thesis was to study the prevalence and severity of persistent TIPN, to investigate its impact on HRQL and to explore the clinical and genetic risk factors for TIPN among early-stage breast cancer survivors (ESBCS).Methods: A population-based cohort of 884 recurrence-free ESBCS diagnosed 2010-2015 in the Southeast Health Care region, Sweden and 1768 control women without prior cancer, who received a postal questionnaire including EORTC chemotherapy-induced peripheral neuropathy (CIPN20) and QLQ-C30 instruments. Prevalence of TIPN symptoms and clinical risk factors were explored. Adjusted relative risks (RR) were estimated for ESBCS compared to control women. For impact on HRQL, adjusted mean scores of QLQ-C30 scales among ESBCS with and without TIPN were calculated. Blood samples from 362 ESBCS were whole-exome sequenced. We leveraged logistic regression models to develop and validate polygenic prediction models to estimate the risk of persistent PN symptoms in a training and test cohort.Results: The response rate was 79% for ESBCS and 59% for controls. The median time post-taxane was 3.6 years. The adjusted RR for ESBCS vs. controls was highest (RR 1.8) for tingling in feet and numbness in feet. Individual sensory symptoms occurred in 9%-48% and motor symptoms in 7%-61% of ESBCS. The most prevalent symptoms were difficulty opening jar and cramps in feet. Paclitaxel, older age, overweight, diabetes mellitus, vibrating hand tools, smoking and autoimmune disease were independent risk factors (Study I). All 13 sensory and motor TIPN symptoms at increased risks among ESBCS had a significant impact on global health status, which worsened with increased severity of TIPN. Between 30%-93% of ESBCS with moderate-severe TIPN reported a clinically important impairment of functioning and personal finances. Moderate-severe difficulty climbing stairs and problems standing/walking were associated with medium-large clinically important differences (Study II). In the explorative sub-study, two of five prediction models based on genetic and clinical risk factors obtained Did you have difficulty hearing?Difficulty hearingPlease answer the following question only if you drive a car Did you have difficulty using the pedals? Difficulty using pedals Docetaxel60+Capecitabin900 2 w x 3-4 Concomitant with EC-T 3w, every 3 weeks; 2w, every 2 weeks; EC, Epirubicin-Cyclophosphamide. Note: As suggested in revision of guidelines.Neoadjuvant chemotherapy is the preferred choice in HER2+ and TNBC due to highly proliferative disease, the possibility to evaluate response (26), and since the evidence as to the efficacy of additional treatments is only shown in trials conducted in a neoadjuvant setting. In HER2+ disease, 'Plus' Increase of sensation Tingling, Burning sensation Allodynia, Hyperalgesia Cramps 'Minus' Loss of function Num...

show abstract

A Review of Treatment-Induced Pulmonary Toxicity in Breast Cancer

Cited by 11 publications

References 97 publications

Whole breast ultrafractionation radiotherapy after breast‐conserving surgery in early breast cancer: A single‐center, prospective, observational study from China

Whole breast ultrafractionation radiotherapy after breast‐conserving surgery in early breast cancer: A single‐center, prospective, observational study from China

Epstein-Barr virus (EBV) induced pneumonitis in a patient with breast cancer receiving neoadjuvant chemotherapy: A case report

Taxane-Induced Peripheral Neuropathy among Early-Stage Breast Cancer Survivors : Prevalence, Risk Factors, Quality of Life and Genetic Prediction Models

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