Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study

Aramita Saha,Subrata Chattopadhyay

doi:10.14319/ijcto.0102.1

Abstract

Background : Anthracycline based regiments and/or taxanes and adjuvant radiotherapy; the main modalities of treatment for breast cancers are associated with deterioration of pulmonary functions and progressive pulmonary toxicities. Aim : Assessment of pulmonary toxicities and impact on pulmonary functions mainly in terms of decline of forced vital capacity (FVC) and the ratio of forced expiratory volume (FEV) in 1 Second and FEV1/FVC ratio with different treatment times and follow ups in carcinoma breast patients receiving anthracycline and/or taxane based chemotherapy and radiotherapy. Materials and methods : A prospective single institutional cohort study was performed with 58 breast cancer patients between January 2011 to July 2012 who received either anthracycline based (37 patients received 6 cycles FAC= 5 FU, Adriamycin, Cyclophosphamide regime) and radiotherapy or anthracycline and taxane based chemotherapy (21 patients received 4cycles AC= Adriamycin, Cyclophosphamide; followed by 4 cycles of T=Taxane) and radiotherapy. Assessment of pulmonary symptoms and signs, chest x-ray and pulmonary function tests were performed at baseline, midcycle, at end of chemotherapy, at end radiotherapy, at 1 and 6 months follow ups and compared. By means of a two-way analysis of variance (ANOVA) model, the course of lung parameters across the time points was compared. Results and Conclusion : Analysis of mean forced vital capacities at different points of study times showed definitive declining pattern, which is at statistically significant level at the end of 6 th month of follow up (p=0.032) .The FEV1/FVC ratio (in percentage) also revealed a definite decreasing pattern over different treatment times and at statistically significant level at 6 th month follow up with p value 0.003. Separate analysis of mean FEV1/FVC ratios over time in anthracycline based chemotherapy and radiotherapy group as well as anthracycline and taxane based chemotherapy and radiotherapy group showed a similar declining pattern. ------------------------- Cite this article as: Saha A, Chattopadhyay S. Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study. Int J Cancer Ther Oncol 2013; 1 (2):01021. DOI : http://dx.doi.org/10.14319/ijcto.0102.1

Highlights

Breast cancer is the leading cause of cancer death among women around the world.[1]
The total dose that can safely be delivered to patients with malignant tumors like carcinoma breast has to be limited because of the risk of radiation pneumonitis and radiation fibrosis
Analysis of mean forced vital capacities at different points of study time (baseline, mid cycle chemotherapy, end of chemotherapy, end of radiotherapy, 1 month and 6 months follow ups showed definitive declining pattern, which is at statistically significant level at the end of 6 th month of follow up (p=0.032) in the entire study population (Table 2, Table 3, and Figure 1)

Summary

Introduction

Breast cancer is the leading cause of cancer death among women around the world.[1]. It accounts for 26% of all malignancies in women and second most common cause of cancer death in women.[2]. Aim: Assessment of pulmonary toxicities and impact on pulmonary functions mainly in terms of decline of forced vital capacity (FVC) and the ratio of forced expiratory volume (FEV) in 1 Second and FEV1/FVC ratio with different treatment times and follow ups in carcinoma breast patients receiving anthracycline and/or taxane based chemotherapy and radiotherapy. Results and Conclusion: Analysis of mean forced vital capacities at different points of study times showed definitive declining pattern, which is at statistically significant level at the end of 6th month of follow up (p=0.032) .The FEV1/FVC ratio (in percentage) revealed a definite decreasing pattern over different treatment times and at statistically significant level at 6th month follow up with p value 0.003. Separate analysis of mean FEV1/FVC ratios over time in anthracycline based chemotherapy and radiotherapy group as well as anthracycline and taxane based chemotherapy and radiotherapy group showed a similar declining pattern

Objectives

Methods

Conclusion