Relationship between radiation pneumonitis and organizing pneumonia after radiotherapy for breast cancer

Abstract

BackgroundRadiation pneumonitis (RP) and organizing pneumonia (OP) are the two main types of lung damage that can occur after lung irradiation. The goal of this study was to evaluate the relationship between RP and OP after irradiation for breast cancer.MethodsFour hundred and twenty-eight patients who underwent radiotherapy for breast cancer were identified. The whole breast was irradiated with two tangential photon beams. Chest computed tomography (CT) scan were performed when patients showed any symptoms that were suspicious for pneumonitis.ResultsFive patients (1.2%) were diagnosed with OP. All five patients showed ground glass opacities and consolidation of the border of the lesion of RP in the radiation fields. Infiltration of OP spread from the site of RP to the hilum of the ipsilateral lung. Between RP and OP, a free region space (FRS) could be detected.ConclusionsOP is closely related to RP. All OP lesions developed near the site of RP.

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.…”

“…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. Boost radiation was given from 0% [23] to 75% [15]. A pulmonary follow-up protocol consisting of scheduled chest radiographs during the year after treatment was used in six studies [15-17, 20, 21, 24], and chest radiographs were performed in three studies if respiratory symptoms developed [18,19,23].…”

“…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.…”

Intraoperative Radiation Therapy for Breast Cancer Not Associated with Pulmonary Complications

“…Unlike RP, COP occurs independent of the radiation dose and outside the radiation field. RP typically occurs in the peripherally in the irradiated lung, while COP can occur outside the radiation field [5].…”