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- W2080520008 abstract "Pulmonary changes following radiation therapy of carcinoma of the breast have been reported frequently with the use of direct portals. In an attempt to deliver adequate radiation to tumor-bearing tissue and at the same time to avoid excessive damage to the lungs, tangential therapy has been used in many countries since 1926 (13). With the establishment of the Radiation Therapy Department at Memorial Center (New York) six years ago, this technic was adopted for irradiation of all inoperable, postoperative, and some recurrent breast carcinomas. It is the purpose of this paper to demonstrate that a tangential technic decreases the incidence and severity of post-irradiation pneumonitis. Review of Literature Pulmonary changes following roentgen treatment of breast carcinoma were first described by Groover, Christie, and Merritt in 1923 (10). From 1923 to 1942 many reports appeared in the literature regarding the pathology, incidence, radiographic appearance, and clinical signs of pulmonary damage following irradiation of cancer of the breast. In the latter year a comprehensive review of the effects of radiation on the lung was given by Warren (24). The pathology of radiation pneumonitis is essentially that of an inflammation. There are edema, congestion, lymphangiectasis, inflammatory cell infiltration, an increased mucus secretion, and desquamation of the alveolar and bronchial epithelium followed by regeneration. Warren and Spencer (25) described a “hyaline membrane” in the alveoli as a reliable diagnostic sign of radiation injury. If the reaction is mild, it subsides in a few weeks or months and leaves little or no evidence of inflammation. In severe cases the inflammatory changes become chronic and may persist for months or years. There are excessive proliferation of connective tissue, chiefly in the alveolar wall, hyalinization and thickening of blood vessel coats, areas of atelectasis, emphysema, and fibrosis. Age and arteriosclerosis have been suggested by Mcintosh and Spitz (19) as factors enhancing the severity of pneumonitis. They pointed out that fibrosis resulted from the repair of damage caused by radiation, but Warren and Spencer (25) thought that secondary infection was more likely responsible. The symptoms of radiation pneumonitis vary from an occasional cough or slight malaise to an acute febrile illness with chest pain, constant cough, and severe dyspnea. The period of fever is usually brief, but the pain, cough, and dyspnea may last several weeks, and in the more severe cases become chronic. In extreme cases, congestive heart failure after several years of chronic progressive pneumonitis has been reported by Freid and Gold-berg (9). Leach (17) found that patients with chronic irradiation “pleuropneumonitis” had an increased ventilation rate, a reduced complementary phase of vital capacity, and a low oxygen absorption." @default.
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- W2080520008 date "1955-05-01" @default.
- W2080520008 modified "2023-09-24" @default.
- W2080520008 title "Pneumonitis Following Radiation Therapy of Cancer of the Breast by Tangential Technic" @default.
- W2080520008 cites W1980842153 @default.
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- W2080520008 doi "https://doi.org/10.1148/64.5.642" @default.
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