[The possible role of some laboratory parameters in predicting radiation-induced lung injury after breast cancer treatment].

Abstract

Introduction: Radiation therapy is a key component in the treatment of breast cancer, but it is often associated with radiation-induced lung injury. The predictive role of peripheral blood parameters in the development of radiation-induced lung injury is not yet well established. Objective: This study aimed to assess whether certain peripheral blood parameters are associated with the development of radiation-induced lung injury in breast cancer patients receiving radiotherapy. Method: In this retrospective study, we analyzed clinical and laboratory data from 94 patients with stage I–III breast cancer who underwent radiotherapy, chemotherapy and/or hormone therapy. The radiation-induced lung injury was diagnosed using imaging techniques (chest X-ray and CT). Blood parameters analyzed included white blood cell count, differential white cell count (neutrophils, lymphocytes, monocytes, eosinophils, basophils), red blood cell count, hemoglobin, and thrombocyte levels. The neutrophil-to-lymphocyte ratio was also calculated. Statistical comparison was performed using the Mann–Whitney U test. Results: Radiation-induced lung injury was confirmed in 43 patients (45.7%). White blood cell count (8.03 ± 8.07 G/L vs. 7.11 ± 6.19 G/L; p = 0.001), neutrophil count (5.17 ± 4.77 G/L vs. 4.82 ± 5.19 G/L; p = 0.006), and monocyte count (0.51 ± 0.26 G/L vs. 0.47 ± 0.36 G/L; p<0.001) were significantly higher in the radiation-induced lung injury-positive group. The neutrophil-to-lymphocyte ratio was also significantly elevated in patients with radiation-induced lung injury (3.62 ± 3.04 vs. 3.13 ± 3.45; p<0.001). No significant differences were found in red blood cell, hemoglobin, or thrombocyte levels. Conclusion: Elevated white blood cell, neutrophil, and monocyte counts, as well as an increased neutrophil-to-lymphocyte ratio may serve as predictive biomarkers of radiation-induced lung injury in breast cancer patients. These routinely available parameters could aid in early detection and risk stratification for radiation-induced lung complications. Further studies with larger cohorts are warranted. Orv Hetil. 2025; 166(29): 1153–1159.