Short-term pulmonary side-effects following radiation therapy in breast cancer

The purpose of this dissertation was to study the short-term pulmonary sideeffects following adjuvant radiotherapy for breast cancer in terms of clinical pulmonary complications, loss of pulmonary function and radiological abnormalities, and the association to irradiated lung volume and dose. Furthermore, we wanted to estimate the influence of covariates, e.g. age, sequential chemotherapy, concurrent tamoxifen treatment, smoking habits, pretreatment functional level and premorbidity, on the early radiation-induced response of lung. Severe pulmonary complications, i.e. managed with corticosteroids, were diagnosed among 10 % of the patients who were treated with loco-regional radiotherapy including the internal mammary nodes (IMN). Age and reduced pre-treatment functional level were independently associated with pulmonary complications. The mean irradiated ipsilateral lung volume receiving more than 20 Gy was larger among the patients diagnosed with both clinical and radiological pneumonitis than in patients experiencing neither of the two side-effects. Severe pulmonary complications were very rare (