Investigation of Pulmonary Complications Induced by Radiotherapy and Chemotherapy in Patients with Breast Cancer through Spirometry, CT Scan Imaging Patterns, and Clinical Criteria in a Six-Month Follow-Up

Abstract

Background: The aim of this study was to determine pulmonary complications induced by radiotherapy and chemotherapy in patients with breast cancer in a six-month follow-up. Method: 80 patients with breast cancer who were referred to the Radio-oncology Center in Kerman were included in the current cohort study. At the baseline, spirometry and lung scan were obtained and all the patients were asked about their respiratory symptoms. After designing the patient’s treatment, dose volume histogram data was extracted. All the tests were repeated six months after radiotherapy. The prevalence of pneumonitis and fibrosis in radiographs were determined clinically and the reduction in the values of pulmonary function test parameters was determined. Results: In 40% of the patients, pulmonary volume was reduced and in 10%, pulmonary fibrosis occurred. Regarding pulmonary function before and six months after radiotherapy, the results revealed that FeV1 (l/s) parameter decreased from 2.68 to 2.48 (P < 0.0001) six months after radiotherapy. FVC parameter also showed a decrease from 3.14 to 2.91 (P < 0.0001) in the same span of time. The odds of developing clinical symptoms in people with pulmonary fibrosis was five times higher than of those without this condition, (OR: 5.51, 95% CI: 1.10 - 27. 42), which was statistically significant (P = 0.03). None of the factors, including mean lung dose, tamoxifen, and age, affected Fev1 and pulmonary fibrosis. Conclusion: Our results indicated that 10% of the patients undergoing treatment for breast cancer developed pulmonary fibrosis and 40% of the patients suffered from reduced pulmonary volumes, which was not associated with chemotherapy regimen or the use of tamoxifen.