Twelve patients were diagnosed of RRP, of who 8 received taxanes. The median time interval between end of radiotherapy and RRP, between end of radiotherapy and beginning of chemotherapy, and between beginning of chemotherapy and RRP was 95 days, 42 days and 47 days, respectively. Marked symptomatic and radiographic improvement was observed in the 12 patients after withdrawal of chemotherapy and application of systemic corticosteroids. Seven patients were rechallenged with chemotherapy, of whom four with the same kind of agents, and showed no recurrence with steroid cover.
One of the side effects of radiation therapy (also called radiotherapy) involves the lungs. When high-energy rays are used to damage cancer cells and stop them from growing and dividing, it is inevitable that normal cells are also affected. Especially after radiation treatments for tumors within the chest or the breast, the lungs may become inflamed. The lung inflammation from radiotherapy is termed radiation pneumonitis. Radiotherapy is usually given on an outpatient basis in a hospital or clinic 5 days a week for several weeks. Radiation pneumonitis tends to show up 2 weeks to 6 months after the end of radiotherapy. By no means is everyone with radiation pneumonitis ill. The radiation pneumonitis may be seen as an incidental finding on a chest x-ray in someone who had radiotherapy but has no symptoms. If symptoms of radiation pneumonitis occur, they may include shortness of breath upon activity, cough and fever. Blood testing usually shows an abnormal white blood count and an elevated sedimentation rate, signs that inflammation may be present somewhere in the body, but not pointing specifically at the lungs. Radiation pneumonitis is often reversible with medications that reduce inflammation, such as the cortisone drugs (prednisone and others). If radiation pneumonitis persists, it can lead to scarring of the lungs, a condition called radiation fibrosis. Radiation fibrosis typically occurs a year after the completion of radiation treatments. Radiation fibrosis is usually not reversible.
We examined radiation pneumonitis in breast cancer patients after breast conservation treatment (BCT) and analysed the degree of radiation-induced lung fibrosis by computed tomographies of the chest (chest CT). Fifty-two breast cancer patients were treated with BCT, including breast irradiation and chemotherapy. These patients symptomatic of radiation pneumonitis were examined every two to four weeks. Chest X-rays and chest CT were performed about one year after irradiation. symptoms due to radiation pneumonitis was registered in % of patients. lungs showed fibrotic changes by chest CT in 90% of the cases. Concurrent or alternative chemotherapy increased the incidence of symptomatic radiation pneumonitis and, to a certain extent, the degree of fibrotic change in the lung after BCT.