Abstract # 2274 A Prospective Study of Radiation Induced Lung Injury: Measured Changes in Pulmonary Symptoms, Physiologic Function and CT Density

Presenter: Lee, Justin

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From 2001 to 2004, 50 patients (35F, 15M) were enrolled. Forty patients were available for follow-up at 3 months, and 34 patients at 6 months. The primary tumour types were lung(n=27), breast(n=20) and esophagus(n=3). Prior to RT, 37%(n=18) reported mild dypnea (grade 2), and 31%(n=15) had mild cough (grade 2). At 1 month, the proportion of patients with dyspnea decreased to 30% (p<0.47, chi-square) and the prevalence of cough decreased to 23%(p<0.43). Similar rates of dyspnea(30%) and cough(28%) were observed at 3 months with no statistically significant change from baseline. No cases of clinical pneumonitis were reported at either 1 or 3 months. At 6 months, 5.7%(n=2) of evaluable patients reported mild late pulmonary toxicity(grade 2). No new cases of severe pulmonary toxicity(grade 3) were reported at 1, 3 or 6 months. The mean changes in PFT parameters for the entire group were not statistically significant at 3 or 6 months. The majority of follow-up CT scans(83%) demonstrate increasing density in the high dose regions of lung compared with pre-RT scans. The mean increases in density were 3.9% at 3 months (p<0.0027, paired t-test) and 5.3% at 6 months (p<0.001). Linear regression analysis was used to compare changes in pulmonary symptom scores, PFT parameters and CT density. At 3-months there was a single statistically significant correlation between the change in FEV(forced expiratory volume in 1 second) and the change in patient dyspnea scores (r=0.614, p=0.019). At 6-months there was no correlation found between any of the three metrics of pulmonary injury.

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