Radiographic and CT features of radiation-induced organizing pneumonia syndrome after breast-conserving therapy

Abstract

The cardinal radiologic feature of this syndrome is airspace consolidation surrounded by ground-glass opacification with airway dilation and volume loss, involving primarily the irradiated, subpleural area, along with distant opacities.

Systematic Review of Postradiotherapy Bronchiolitis Obliterans Organizing Pneumonia in Women With Breast Cancer

“…Ten Japanese epidemiological studies were identified [15][16][17][18][19][20][21][22][23][24]. Several studies were from a single institution [16,17,20,21,23,24], and one study was a survey among 20 institutions (Table 1) [18].…”

“…Several studies were from a single institution [16,17,20,21,23,24], and one study was a survey among 20 institutions (Table 1) [18]. These reports described BOOP occurring in 129 of 7,671 women (1.7%), and studies showed a range of prevalence from 0.8% to 2.9% [15][16][17][18][19][20][21][22][23][24]. Five of the 9 reports showed patients received a traditional whole-breast irradiation protocol of 50 Gy in 25 fractions [19][20][21]23, 24], 1 report showed 248 patients received hypofractionated whole-breast radiotherapy [17], 1 report included patients who received whole-breast irradiation or accelerated hyperfractionated whole-breast irradiation [15], and there was no information about the radiation protocol for 3 reports.…”

“…The majority of women received hormonal therapy, and those receiving chemotherapy ranged from 0% [22] to 60% [23]. The latency period to onset of pulmonary symptoms ranged from onset during radiation therapy [18] to 23 months after completion of therapy [20].…”

“…Contralateral involvement of BOOP occurred from 8% [21] to 100% [17]. Regarding corticosteroid treatment, none of the patients received this treatment in a study in which 50% of patients Postradiation BOOP CME were asymptomatic [21]; 1 study reported that 27% received corticosteroid [24], 4 studies reported that more than 50% received corticosteroid therapy [18][19][20]22], and 4 reports showed that 100% of patients received corticosteroid therapy [15][16][17]23]. Relapses ranged from 0% to 100% [15,18], and one patient had five relapses [23].…”

“…Additional reports were published from the United States, Japan, and other countries [6,. Large-scale epidemiological reports have been published from Japan, where prevalence ranged from 0.8% to 2.9% [15][16][17][18][19][20][21][22][23][24]. Most of these patients received traditional whole-breast irradiation.…”