To delineate the risk factors associated with radiation pneumonitis (RP) in breast cancer patients receiving adjuvant radiotherapy.
Approach:
Study Design: A retrospective analysis was performed on 811 female patients who underwent postoperative radiotherapy for breast cancer.
Statistical Analysis: Univariate analysis was employed to identify factors associated with RP, followed by multivariate logistic regression modeling to determine independent risk factors.
Predictive Performance: Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of identified risk factors.
Key Findings:
Univariate analysis identified tumor stage, chest wall + supraclavicular + internal mammary lymph node irradiation (CSI), number of chemotherapy cycles, ipsilateral lung V5, V10, V20, and mean lung dose (MLD) as significantly associated with RP (all P < 0.05).
Multivariate analysis confirmed MLD (odds ratio [OR] = 11.136, 95% confidence interval [CI]: 5.494 ∼22.571; P < 0.001), number of chemotherapy cycles (OR = 2.739, 95% CI: 1.597 ∼ 4.696; P < 0.001), and CSI (OR = 5.654, 95% CI: 1.768 ∼ 18.080; P = 0.003) as independent risk factors for RP.
MLD threshold of 12.70 Gy showed predictive sensitivity of 0.898 and specificity of 0.965 for RP.
Interpretation:
MLD, number of chemotherapy cycles, and CSI are significant risk factors for RP in breast cancer patients undergoing adjuvant radiotherapy.
Limitations:
The study is retrospective and may be subject to selection bias.
Findings may not be generalizable to all breast cancer patient populations.
Conclusion:
MLD, number of chemotherapy cycles, and CSI are significant risk factors for RP in breast cancer patients undergoing adjuvant radiotherapy.
