Titre :

Radiation-induced lung injury after breast cancer treatment: incidence in the CANTO-RT cohort and associated clinical and dosimetric risk factors

Auteur(s) :

Gueiderikh, Anna [Auteur]
Institut Gustave Roussy [IGR]
Sarrade, Thomas [Auteur]
CHU Tenon [AP-HP]
Kirova, Youlia M. [Auteur]
Institut Curie [Paris]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
de la Lande, Brigitte [Auteur]
Institut Curie [Paris]
de Vathaire, Florent [Auteur]
Centre de recherche en épidémiologie et santé des populations [CESP]
Auzac, Guillaume [Auteur]
Institut Gustave Roussy [IGR]
Martin, Anne Laure [Auteur]
UNICANCER
Everhard, Sibille [Auteur]
UNICANCER
Meillan, Nicolas [Auteur]
Centre Hospitalier Victor Dupouy
Centre de recherche en épidémiologie et santé des populations [CESP]
Bourgier, Céline [Auteur]
UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle [ICM]
Institut de Recherche en Cancérologie de Montpellier [IRCM - U1194 Inserm - UM]
Université de Montpellier [UM]
Benyoucef, Ahmed [Auteur]
Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel]
Lacornerie, Thomas [Auteur]
Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] [UNICANCER/Lille]
Pasquier, David [Auteur]
Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 [CRIStAL]
Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] [UNICANCER/Lille]
Racadot, Séverine [Auteur]
Département cancer environnement (Centre Léon Bérard - Lyon)
Moignier, Alexandra [Auteur]
Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO]
Paris, François [Auteur]
Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes-Angers [CRCI2NA ]
Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO]
André, Fabrice [Auteur]
Prédicteurs moléculaires et nouvelles cibles en oncologie [PMNCO]
Institut Gustave Roussy [IGR]
Deutsch, Eric W. [Auteur]
Radiothérapie Moléculaire et Innovation Thérapeutique [RaMo-IT]
Institut Gustave Roussy [IGR]
Duchemann, Boris [Auteur]
Hôpital Avicenne [AP-HP]
Allodji, Rodrigue S. [Auteur]
Centre de recherche en épidémiologie et santé des populations [CESP]
Rivera, Sofia [Auteur]
Radiothérapie Moléculaire et Innovation Thérapeutique [RaMo-IT]
Institut Gustave Roussy [IGR]

Titre de la revue :

FRONTIERS IN ONCOLOGY

Éditeur :

Frontiers Media

Date de publication :

2023

ISSN :

2234-943X

Mot(s)-clé(s) en anglais :

breast cancer
CANTO cohort
dosimetric analyses
lug fibrosis
radiation therapy
radio-induced lung injury
RILI

Discipline(s) HAL :

Sciences du Vivant [q-bio]/Cancer

Résumé en anglais : [en]

Purpose: Radiation-induced lung injury (RILI) is strongly associated with various clinical conditions and dosimetric parameters. Former studies have led to reducing radiotherapy (RT) doses to the lung and have favored the ...
Lire la suite >Purpose: Radiation-induced lung injury (RILI) is strongly associated with various clinical conditions and dosimetric parameters. Former studies have led to reducing radiotherapy (RT) doses to the lung and have favored the discontinuation of tamoxifen during RT. However, the monocentric design and variability of dosimetric parameters chosen have limited further improvement. The aim of our study was to assess the incidence of RILI in current practice and to determine clinical and dosimetric risk factors associated with RILI occurrence. Material and methods: Data from 3 out of the 10 top recruiting centers in CANTO-RT, a subset of the CANTO prospective longitudinal cohort (NCT01993498), were retrospectively analyzed for RILI occurrence. This cohort, which recruited invasive cT0-3 cN0-3 M0 breast cancer patients from 2012 to 2018, prospectively recorded the occurrence of adverse events by questionnaires and medical visits at the end of, and up to 60 months after treatment. RILI adverse events were defined in all patients by the association of clinical symptoms and compatible medical imaging. Results: RILI was found in 38/1565 (2.4%) patients. Grade II RILI represented 15/38 events (39%) and grade III or IV 2/38 events (6%). There were no grade V events. The most frequently used technique for treatment was 3D conformational RT (96%). In univariable analyses, we confirmed the association of RILI occurrence with pulmonary medical history, absence of cardiovascular disease medical history, high pT and pN, chemotherapy use, nodal RT. All dosimetric parameters were highly correlated and had close predictive value. In the multivariable analysis adjusted for chemotherapy use and nodal involvement, pulmonary medical history (OR=3.05, p<0.01) and high V30 Gy (OR=1.06, p=0.04) remained statistically significant risk factors for RILI occurrence. V30 Gy >15% was significantly associated with RILI occurrence in a multivariable analysis (OR=3.07, p=0.03). Conclusion: Our study confirms the pulmonary safety of breast 3D RT in CANTO-RT. Further analyses with modern radiation therapy techniques such as IMRT are needed. Our results argue in favor of a dose constraint to the ipsilateral lung using V30 Gy not exceeding 15%, especially in patients presenting pulmonary medical history. Pulmonary disease records should be taken into account for RT planning. CopyrightLire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Projet ANR :

Etude des toxicités chroniques des traitements anticancéreux chez les patientes porteuses cancer

Collections :

• Centre de Recherche en Informatique, Signal et Automatique de Lille (CRIStAL) - UMR 9189

Source :

Harvested from HAL