Pneumonitis and pulmonary fibrosis associated with breast cancer treatments

Omarini, Claudia; Thanopoulou, Eirini; Johnston, Stephen

doi:10.1007/s10549-014-3016-5

Cited by 52 publications

(41 citation statements)

References 112 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This method includes the entire breast parenchyma, but it is also irradiates other tissues: the skin, ipsilateral lung, heart, and contralateral breast. Therefore, radiation-induced morbidity can occur [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts

Kim

2016

Oncotarget

View full text Add to dashboard Cite

Prone position radiotherapy for a small (< 750 cm3) breast is controversial because of the variable benefits for the irradiated heart volume. The objective anatomical parameters related with chest wall shape that can determine the heart dose sparing patients in the prone position.Twenty-one patients underwent CT-simulation in supine and prone position. Dose volume parameters were compared and the objective indexes such as the Haller index, anthropometric index, mid-sternum thickness, and central lung distance (CLD) were evaluated the relationship between the shape of the chest wall and irradiated normal tissue volume in prone position.The median breast volume was 440.10 cm3 (range, 151.5–727.41 cm3). There was no difference of breast target volume between supine and prone position (p = 0.178). The Haller index under 2.5 (p = 0.046), an anthropometric index over 0.05 (p = 0.007), and the CLD over 2 (p = 0.023) conferred a greater heart sparing effect in the prone position.In conclusions, the objective anatomical parameters related chest wall shape predict the decrease in irradiated heart volume in the prone position. Therefore, it is possible to screen for patients with a reduced heart volume irradiation among those with small breasts before applying prone position radiotherapy.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts

Kim

2016

Oncotarget

View full text Add to dashboard Cite

show abstract

“…The first one is direct damage to the pneumocytes either via chemical injury to normal lung tissue [9] or in the case of bleomycin, the release of free reactive oxygen species [9-10]. Capillary leak syndrome, which is direct damage to the endothelium of the pulmonary vessels leading to increased vessel permeability and ultimately, pleural effusion, has been suggested as the second method [11]. While the third mechanism proposes an acute or delayed hypersensitivity reaction to explain the underlying pathophysiology [9, 11].…”

Section: Reviewmentioning

confidence: 99%

“…Capillary leak syndrome, which is direct damage to the endothelium of the pulmonary vessels leading to increased vessel permeability and ultimately, pleural effusion, has been suggested as the second method [11]. While the third mechanism proposes an acute or delayed hypersensitivity reaction to explain the underlying pathophysiology [9, 11]. Drugs themselves can act as haptens or antigens that can lead to immune-mediated lung damage [9, 12].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacological Threat to Lungs: A Case Series and Literature Review

Irfan¹,

Gilani²,

Irshad³

et al. 2017

Cureus

View full text Add to dashboard Cite

Drug-induced organ damage stands as a prevalent yet much-neglected issue globally. Keeping in view it’s rising frequency, health care providers stand obliged to be well versed with the de-merits of the agents they prescribe. Drug therapies causing damage present with a non-specific clinical presentation, histological findings or radiology, which further elaborates on the necessity of a conscientious diagnosis. Pulmonary architecture ranging from the airways, lung parenchyma, mediastinum, pleura, pulmonary vasculature or the neuromuscular system, all can fall victim to the dreaded outcomes of this menace. In order to establish successful diagnosis, the definite temporal relation between initiation of drug therapy and the development of the respiratory symptoms needs to be drawn. The most common form of pharmacologically arising lung toxicity is drug-induced pneumonitis or interstitial lung disease. Unfortunately, there is no adequate data available to review the extensiveness of this medication-associated risk in Pakistan which further highlights the necessity of carefully monitoring this overlooked yet assessable malady. Furthermore, identification and surveillance of this drug attributed peril shall help diminish burden on healthcare resources of the country. We present three recent cases of different types of drug-induced lung damage under treatment at our University Hospital.

show abstract

“…Cosmetic outcomes can be worsened by inhomogeneous irradiation, especially for patients have small breasts, a common feature of Asians. [3,4] …”

Section: Introductionmentioning

confidence: 99%

Small-arc volumetric-modulated arc therapy

Chen

2016

Medicine

View full text Add to dashboard Cite

Volumetric-modulated arc therapy (VMAT) is considered to deliver a better dose distribution and to shorten treatment time. There is a lack of research regarding breast irradiation after breast-conserving surgery (BCS) using VMAT with prone positioning. We developed a new small-arc VMAT methodology and compared it to conventional (fixed-field) intensity-modulated radiation therapy (IMRT) in the dosimetric and treatment relevant parameters for breast cancer patients in the prone position.Ten early-stage breast cancer patients were included in this exploratory study. All patients underwent computed tomography (CT) simulation scan in the prone position and for each patient, IMRT and VMAT plans were generated using the Monaco planning system. Two symmetrical partial arcs were applied in the VMAT plans. The angle ranges of the 2 arcs were set to approximately 60° to 100° and 220° to 260°, with small adjustments to maximize target coverage, while minimizing lung and heart exposure. The IMRT plans used 4 fixed fields. Prescribed doses were 50 Gy in 25 fractions. The target coverage, homogeneity, conformity, dose to organs at risk (OAR), treatment time, and monitor units (MU) were evaluated.Higher median conformal index (CI) and lower homogeneity index (HI) of the planning target volume (PTV) were respectively observed in VMAT and plans group (CI, 95% vs 91%; HI, 0.09 vs 0.12; P < 0.001). The volumes of ipsilateral lung receiving 30, 20, 10, and 5 Gy were lower for VMAT (P < 0.01), being 10%, 14.9%, 25.9%, and 44.9%, respectively, compared to 11.79%, 17.32%, 30.27%, and 50.58% for the IMRT plans. The mean lung dose was also reduced from 10.6 ± 1.8 to 9.6 ± 1.4 Gy (P = 0.001). The volumes of the heart receiving 30 and 40 Gy were similar for the 2 methods. In addition, the median treatment time (161 vs 412 seconds; P < 0.001) and the mean MU (713 vs 878; P < 0.001) were lower for VMAT.Small-arc VMAT plan improved CI and HI for the target, spared the dose of lung, and reduced treatment time and MU, compared to IMRT. It is a more promising irradiation technique for post-BCS radiotherapy.

show abstract

Pneumonitis and pulmonary fibrosis associated with breast cancer treatments

Cited by 52 publications

References 112 publications

Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts

Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts

Pharmacological Threat to Lungs: A Case Series and Literature Review

Small-arc volumetric-modulated arc therapy

Contact Info

Product

Resources

About