The Use of Imaging in the Prediction and Assessment of Cancer Treatment Toxicity
- Hossein Jadvar
We investigated the lung toxicity of chemotherapeutic drugs in patients with breast cancer by means of Tc-99m DTPA aerosol scintigraphy. Thirty three patients who underwent surgical resection for breast cancer were divided into two groups, those who received a combination of adjuvant chemotherapy and those who did not. Group 1 consisted of 19 patients who received adjuvant chemotherapy and group 2 consisted of 14 patients who did not received adjuvant chemotherapy. Chemotherapeutic agents included 5-fluorouracil 1000 mg, endoxan 1000 mg and MTX 50 mg, all given intravenously. Aerosol lung scintigraphy was performed in all patients, in the supine position. The degree of lung damage was presented as the half clearance time (T 1/2) in minutes from the dynamic lung images. Only the right lung was used to analyze clearance, in order to avoid interference from stomach activity on the left side. The results show T 1/2 times of 68.18 +/- 20.04 min and 94.46 +/- 34.78 min, over the right lung, for groups 1 and 2, respectively. The difference is significant, with a p-value of 0.016, using the Mann-Whitney U test. We conclude that some chemotherapeutic drugs such as MTX, may result in pulmonary damage and that aerosol lung scintigraphy can provide an objective mean for early detection of pulmonary damage during cytotoxic chemotherapy.