Bronchiolitis obliterans organizing pneumonia syndrome primed by radiation therapy to the breast
Bronchiolitis obliterans organizing pneumonia syndrome primed by radiation therapy to the breast
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DOI：
10.1164/ajrccm.158.6.9711036
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发表时间：
1998-12-01
影响因子：
24.7
通讯作者：
Cordier, JF
中科院分区：
文献类型：
--
作者：
Crestani, B;Valeyre, D;Cordier, JF
乳腺癌放射治疗后女性发生闭塞性细支气管炎机化性肺炎 (BOOP) 的报告表明，肺部放射可能参与了 BOOR 的发生。现在，我们描述了向法国“Orphelines”肺病研究小组 (CERM"O"P) 报告的 15 名患者的临床、放射学、功能和支气管肺泡灌洗特征。所有 15 名女性（60 +/- 6 岁）均满足以下纳入标准：(1) 12 个月内对乳房进行放射治疗，(2) 一般和/或呼吸道症状持续至少 2 周，(3) 放射端口外肺部浸润，(4) 无特定原因。患者表现为发烧、干咳、轻度呼吸困难，胸片显示周围肺泡混浊，具有特征性的迁移模式。肺部病理分析发现 5 名患者出现 ROOF。所有患者在使用皮质类固醇后均获得显着改善，但 12 名患者在逐渐减量或停止皮质类固醇后出现复发。该报告表明，对乳房进行放射治疗后可能会出现特征性的 BOOP 综合征，包括对肺部的切向放射，因此表明放射治疗可能会促进 ROOF 的发生。
Reports of bronchiolitis obliterans organizing pneumonia (BOOP) occurring in women after radiation therapy for breast cancer have suggested that radiation to the lung could participate in the development of BOOR. We now describe the clinical, radiographic, functional, and bronchoalveolar lavage characteristics of this syndrome in a series of 15 patients reported to the Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (CERM"O"P) in France. All 15 women (60 +/- 6 yr of age) fulfilled the following inclusion criteria: (1) radiation therapy to the breast within 12 mo, (2) general and/or respiratory symptoms lasting for at least 2 wk, (3) lung infiltrates outside the radiation port, and (4) no specific cause. The patients presented with fever, nonproductive cough, mild dyspnea, and peripheral alveolar opacities on chest radiograph with a characteristic migratory pattern. In five patients, ROOF was found at lung pathologic analysis. In all the patients dramatic improvement was obtained with corticosteroids, but relapses occurred in 12 patients while tapering or after stopping corticosteroids. This report demonstrates that a characteristic BOOP syndrome may occur after radiation therapy to the breast, including tangential radiation to the lung, thus suggesting that radiation therapy may prime the development of ROOF.