Bentzen et al reported

Bentzen et al. reported enhanced RT-induced pulmonary fibrosis in patients treated with AZD8931 concomitant tamoxifen [29]. This effect was not observed in our cohort of patients. In accordance with Wennemberg et al. [25] no correlation was found between HU and either chemotherapy or TAM. Nevertherless the very low incidence

AG-014699 in vitro of lung toxicity was certainly also related, in our series, to the very low values of doses administered to the lung volume as shown from the calculated dose volume histograms. Statistically significant changes in toxicity ≥G2 and ≥G1 based on DLCO (p = 0.006 and p = 0.034, respectively) were detected when comparing data of patients who did receive chemo-therapy and those who did not, but no adjunctive effects were seen due to radiotherapy. These findings are in accordance with the low observed mean DLCO caused by the adjuvant chemotherapy [27, 30]. This confirms that DLCO is a more sensitive variable of functional pulmonary changes due to drug-induced toxicity. These differences were lost at Bindarit 2 years post-radiotherapy indicating recovery over time and no additional influence of hypo-fractionated radiotherapy schedule. These results confirm the literature [27], indicating a trend towards normalization at 5 months after radiotherapy. FEV1% showed a significant correlation

with smoking habits for ≥G1 toxicity at 2-years post-radiotherapy. Our findings support the hypothesis that this new hypofractionated schedule neither implies a detriment of functional breathing nor hinders from the recovery over time. Conclusion The radiotherapy schedule investigated in this study (i.e 34 Gy in 3.4 Gy/fr plus boost dose of 8 Gy in single fraction) is a feasible and safe treatment and does not lead to adjunctive acute and late toxicities. A longer follow up is expected to confirm these favourable results. Still, randomized prospective studies, designed to validate accelerated hypofractionated schedules, should be encouraged. References 1. Veronesi U, Marubini E, Mariani L, Galimberti V, Luini A, Veronesi P, Salvadori B, Zucali R: Radiotherapy after breast-conserving

surgery in small breast carcinoma. Long-term results of a randomized trial. Ann Oncol 2000, 12:997–1003.CrossRef 2. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002, 347:1233–1241.PubMedCrossRef 3. Early Breast Cancer Trialist’s Collaborative Group: Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005, 366:2087–2106. 4. Fowler JF: The linear-quadratic formula and progress in fractionated radiotherapy.

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