{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:32:58Z","timestamp":1777926778445,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1181","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan","award":["BR24992933"],"award-info":[{"award-number":["BR24992933"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Postoperative radiotherapy (RT) for breast cancer (BC) improves survival by preventing local recurrence but can lead to radiation-induced pulmonary fibrosis (RIPF). RIPF typically appears within 6-12\u2009months post-RT and may progress over 2 years. This study assessed RIPF development in BC patients undergoing hypofractionated RT and evaluated the effects of rehabilitation interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 209 BC patients were observed: 106 in the study group received rehabilitation, while 103 in the control group followed the standard protocol. Rehabilitation included medications (Aquadetrim, Adenorin, Contimax, Magnesium B6) and topical sodium nucleonate spray. All patients received an average dose of 42.56\u2009Gy over 16 sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RIPF developed in 90.3% of patients, with an average onset at 8.7\u2009months post-RT. Rehabilitation delayed RIPF onset\u2014by 8.9\u2009months in the control group vs. 9.8\u2009months in the rehabilitation group\u2014showing a 9.9% improvement (P\u2009=\u2009.034). Body mass index (BMI) was a significant factor: patients with BMI &amp;gt;25 developed RIPF earlier (7.5\u2009months) than those with BMI &amp;lt;25 (11.3\u2009months, P\u2009=\u2009.005). Age and cancer side had no significant effect, though right-sided BC showed slightly earlier onset. Grade 2 skin reactions were linked to higher fibrosis incidence, though not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rehabilitation may delay RIPF onset, and BMI appears to be a strong predictor of its development. Future research should explore additional risk factors for RIPF in BC patients post-RT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This study is among the first to show that targeted rehabilitation protocols may effectively delay RIPF onset after hypofractionated RT in BC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag003","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T03:31:49Z","timestamp":1767929509000},"page":"886-897","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary fibrosis and its rehabilitation after radiation therapy for breast cancer"],"prefix":"10.1093","volume":"99","author":[{"given":"Serzhan","family":"Nazarbek","sequence":"first","affiliation":[{"name":"Club of Experts under the Senate of Republic of Kazakhstan , Astana 010000, Republic of","place":["Kazakhstan"]},{"name":"Kazakhstan Association of Healthcare Managers , Astana 010000, Republic of","place":["Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilyara","family":"Kaidarova","sequence":"additional","affiliation":[{"name":"Kazakh Institute of Oncology and Radiology , Almaty 050000, Republic of","place":["Kazakhstan"]},{"name":"Department of Oncology, Kazakh National Medical University named after S.D. Asfendiyarov , Almaty 050000, Republic of","place":["Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yevgeniy","family":"Ishkinin","sequence":"additional","affiliation":[{"name":"Kazakh Institute of Oncology and Radiology , Almaty 050000, Republic of","place":["Kazakhstan"]},{"name":"Almaty Oncology Center , Almaty 050054, Republic of","place":["Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saniya","family":"Ossikbayeva","sequence":"additional","affiliation":[{"name":"Center for Molecular Genetic Research, Kazakh Institute of Oncology and Radiology , Almaty 050000, Republic of","place":["Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9696-7336","authenticated-orcid":false,"given":"Tatyana","family":"Goncharova","sequence":"additional","affiliation":[{"name":"Department of Scientific Management and Grant Research, Kazakh Institute of Oncology and Radiology , Almaty 050000, Republic of","place":["Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"2026050118214114900_tqag003-B1","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/j.ijrobp.2023.10.026","article-title":"Pulmonary function and lung fibrosis up to 12 years after breast cancer radiotherapy","volume":"118","author":"Karlsen","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026050118214114900_tqag003-B2","doi-asserted-by":"publisher","first-page":"1481242","DOI":"10.3389\/fonc.2024.1481242","article-title":"COVID-19 pandemic shifted epidemiology for cancer screening sites: breast, cervix, colon, and rectum","volume":"14","author":"Ishkinin","year":"2024","journal-title":"Front Oncol"},{"key":"2026050118214114900_tqag003-B3","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1080\/0284186X.2021.1976828","article-title":"Pneumonitis and fibrosis after breast cancer radiotherapy: occurrence and treatment-related predictors","volume":"60","author":"Karlsen","year":"2021","journal-title":"Acta Oncol"},{"key":"2026050118214114900_tqag003-B4","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s10549-014-3016-5","article-title":"Pneumonitis and pulmonary fibrosis associated with breast cancer treatments","volume":"146","author":"Omarini","year":"2014","journal-title":"Breast Cancer Res Treat"},{"key":"2026050118214114900_tqag003-B5","doi-asserted-by":"publisher","first-page":"913","DOI":"10.3390\/jpm13060913","article-title":"Awareness and compliance with the recommendations of primary and secondary prevention of cancer in patients with inflammatory bowel disease","volume":"13","author":"Tulewicz-Marti","year":"2023","journal-title":"J Pers Med"},{"key":"2026050118214114900_tqag003-B6","doi-asserted-by":"publisher","first-page":"1758835921989223","DOI":"10.1177\/1758835921989223","article-title":"Aflibercept or bevacizumab in combination with FOLFIRI as second-line treatment of mRAS metastatic colorectal cancer patients: the ARBITRATION study protocol","volume":"13","author":"Ottaiano","year":"2021","journal-title":"Ther Adv Med Oncol"},{"key":"2026050118214114900_tqag003-B7","doi-asserted-by":"publisher","first-page":"641","DOI":"10.3390\/jpm11070641","article-title":"Evolution of ct findings and lung residue in patients with covid-19 pneumonia: quantitative analysis of the disease with a computer automatic tool","volume":"11","author":"Grassi","year":"2021","journal-title":"J Pers Med"},{"key":"2026050118214114900_tqag003-B8","doi-asserted-by":"publisher","first-page":"81","DOI":"10.17650\/1994-4098-2024-20-4-81-87","article-title":"Installation of preoperative and intraoperative fiducial markers for radiation therapy in mammary gland surgery (literature review)","volume":"20","author":"Abdrakhmanova","year":"2024","journal-title":"Opuholi \u017denskoj Reproduktivnoj Sistemy"},{"key":"2026050118214114900_tqag003-B9","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1023\/a:1012292019599","article-title":"Pulmonary complications following different radiotherapy techniques for breast cancer, and the association to irradiated lung volume and dose","volume":"68","author":"Lind","year":"2001","journal-title":"Breast Cancer Res Treat"},{"key":"2026050118214114900_tqag003-B10","doi-asserted-by":"publisher","first-page":"62","DOI":"10.17650\/1994-4098-2024-20-4-62-69","article-title":"Prevention of tumors in treating fibrocystic breast diseases using Vitex agnus-castus-based herbal remedy","volume":"20","author":"Omarbayeva","year":"2024","journal-title":"Tumors Female Reprod Syst"},{"key":"2026050118214114900_tqag003-B11","doi-asserted-by":"publisher","first-page":"99","DOI":"10.2152\/jmi.56.99","article-title":"Risk factors for radiation pneumonitis caused by whole breast irradiation following breast-conserving surgery","volume":"56","author":"Kubo","year":"2009","journal-title":"J Med Invest"},{"key":"2026050118214114900_tqag003-B12","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1093\/jnci\/88.13.918","article-title":"Radiotherapy-related lung fibrosis enhanced by tamoxifen","volume":"88","author":"Bentzen","year":"1996","journal-title":"J Nat Cancer Inst"},{"key":"2026050118214114900_tqag003-B13","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/s0167-8140(02)00136-6","article-title":"Effects of tamoxifen on pulmonary fibrosis after cobalt-60 radiotherapy in breast cancer patients","volume":"64","author":"Koc","year":"2002","journal-title":"Radiother Oncol"},{"key":"2026050118214114900_tqag003-B14","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.chest.2019.03.033","article-title":"Radiation-induced lung injury: assessment and management","volume":"156","author":"Hanania","year":"2019","journal-title":"Chest"},{"key":"2026050118214114900_tqag003-B15","doi-asserted-by":"publisher","first-page":"1199043","DOI":"10.3389\/fonc.2023.1199043","article-title":"Radiation-induced lung injury after breast cancer treatment: incidence in the CANTO-RT cohort and associated clinical and dosimetric risk factors","volume":"13","author":"Gueiderikh","year":"2023","journal-title":"Front Oncol"},{"key":"2026050118214114900_tqag003-B16","doi-asserted-by":"publisher","first-page":"860","DOI":"10.18632\/oncotarget.28518","article-title":"Determination of genetic predisposition to early breast cancer in women of Kazakh ethnicity","volume":"14","author":"Zhunussova","year":"2023","journal-title":"Oncotarget"},{"key":"2026050118214114900_tqag003-B17","doi-asserted-by":"crossref","unstructured":"Goncharova T, Kaidarova D, Omarbayeva N, et al \u00a0Epigenetic markers-based breast cancer early detection method development. Oncol Radiol Kazakh. 2020;58:29-35. http:\/\/dx.https:\/\/doi.org\/10.52532\/2663-4864-2020-4-58-29-35","DOI":"10.52532\/2663-4864-2020-4-58-29-35"},{"key":"2026050118214114900_tqag003-B18","doi-asserted-by":"publisher","first-page":"90","DOI":"10.17650\/2313-805X-2023-10-2-90-99","article-title":"The specifics of CpG islets methylation of some genes of peripheral blood T-lymphocytes in breast cancer patients before and after treatment","volume":"10","author":"Goncharova","year":"2023","journal-title":"Usp Mol Onkol"},{"key":"2026050118214114900_tqag003-B19","doi-asserted-by":"publisher","first-page":"85","DOI":"10.30683\/1929-2279.2024.13.12","article-title":"Current developments and innovations in early detection and subsequent treatment of cancer","volume":"13","author":"Goxharaj","year":"2024","journal-title":"J Can Res Updates"},{"key":"2026050118214114900_tqag003-B20","doi-asserted-by":"publisher","first-page":"4043","DOI":"10.31557\/APJCP.2024.25.11.4043","article-title":"Review of quality audit in a radiation oncology department in a tertiary care hospital-2 year results","volume":"25","author":"Kumaar","year":"2024","journal-title":"Asian Pac J. Cancer Prev"},{"key":"2026050118214114900_tqag003-B21","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1007\/s00432-015-1974-6","article-title":"Radiation-induced fibrosis: mechanisms and implications for therapy","volume":"141","author":"Straub","year":"2015","journal-title":"J Cancer Res Clin Oncol"},{"key":"2026050118214114900_tqag003-B22","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/978-3-031-72862-4_6","volume-title":"A Prehabilitation Guide for All Providers","author":"Brown","year":"2024"},{"key":"2026050118214114900_tqag003-B23","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1186\/s13014-020-01654-9","article-title":"Radiation-induced lung toxicity\u2014cellular and molecular mechanisms of pathogenesis, management, and literature review","volume":"15","author":"K\u00e4smann","year":"2020","journal-title":"Radiat Oncol"},{"key":"2026050118214114900_tqag003-B24","doi-asserted-by":"publisher","first-page":"99","DOI":"10.14739\/2310-1237.2015.1.42937","article-title":"Pathomorphological features of pulmonary tuberculoma (according to the analysis of operational resection material)","volume":"0","author":"Kuzyk","year":"2015","journal-title":"Patolog\u00ec\u00e2"},{"key":"2026050118214114900_tqag003-B25","doi-asserted-by":"publisher","first-page":"482","DOI":"10.47307\/GMC.2025.133.2.19","article-title":"Treatment compliance for pulmonary tuberculosis patients: Analysis of internal and external factors at Mandai health center, Maros regency, Indonesia","volume":"133","author":"Kaderiah Noor","year":"2025","journal-title":"Gac Med Caracas"},{"key":"2026050118214114900_tqag003-B26","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1097\/00130404-200509000-00006","article-title":"Body mass index predicts the incidence of radiation pneumonitis in breast cancer patients","volume":"11","author":"Allen","year":"2005","journal-title":"Cancer J"},{"key":"2026050118214114900_tqag003-B27","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1200\/JCO.2016.34.15_suppl.1049","article-title":"Effect of elevated BMI on radiation toxicity in early stage breast cancer patients","volume":"34","author":"Silberg","year":"2016","journal-title":"JCO"},{"key":"2026050118214114900_tqag003-B28","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.semradonc.2014.12.003","article-title":"Nondosimetric risk factors for radiation-induced lung toxicity","volume":"25","author":"Kong","year":"2015","journal-title":"Semin Radiat Oncol"},{"key":"2026050118214114900_tqag003-B29","doi-asserted-by":"publisher","first-page":"S173","DOI":"10.21037\/tcr.2019.08.28","article-title":"Radiotherapy in elderly patients with breast cancer: a literature review of acute and late toxicity","volume":"9","author":"Zamagni","year":"2020","journal-title":"Transl Cancer Res"},{"key":"2026050118214114900_tqag003-B30","doi-asserted-by":"publisher","first-page":"254","DOI":"10.14739\/2310-1210.2022.2.233123","article-title":"Idiopathic granulomatous mastitis: a clinical case and a review of the literature","volume":"24","author":"Shuliha-Nedaikhliebova","year":"2022","journal-title":"ZMJ"},{"key":"2026050118214114900_tqag003-B31","doi-asserted-by":"publisher","first-page":"959","DOI":"10.47307\/GMC.2025.133.3.25","article-title":"Guided imagery intervention improves the quality of life in breast cancer patients: a literature review","volume":"133","author":"Sulasri Zulkifli","year":"2025","journal-title":"Gac Med Caracas"},{"key":"2026050118214114900_tqag003-B32","doi-asserted-by":"publisher","first-page":"3347","DOI":"10.31557\/APJCP.2025.26.9.3347","article-title":"mTOR levels and metastasis in luminal breast cancer: Implications for prognosis and treatment","volume":"26","author":"Nur","year":"2025","journal-title":"Asian Pac J Cancer Prev"},{"key":"2026050118214114900_tqag003-B33","unstructured":"Greenblat M, Johnson C, Mangino A, et al \u00a0Mastectomy for severe radiation-induced fibrosis following breast conservation therapy. Clin Case Rep J. 2022;3:1-8. 10.5281\/zenodo.14894683"},{"key":"2026050118214114900_tqag003-B34","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.canrad.2021.04.007","article-title":"Impact of adjuvant radiotherapy on biological and clinical parameters in right-sided breast cancer","volume":"25","author":"Lauffer","year":"2021","journal-title":"Cancer Radiother"},{"key":"2026050118214114900_tqag003-B35","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.ijrobp.2010.04.067","article-title":"Impact of the radiation boost on outcomes after breast-conserving surgery and radiation","volume":"81","author":"Murphy","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026050118214114900_tqag003-B36","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1093\/annonc\/mds066","article-title":"Long-term cosmetic changes after breast-conserving treatment of patients with stage I-II breast cancer and included in the EORTC \u201cboost versus no boost\u201d trial","volume":"23","author":"Immink","year":"2012","journal-title":"Ann Oncol"},{"key":"2026050118214114900_tqag003-B37","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.adro.2017.10.007","article-title":"Predictors of radiation-induced acute skin toxicity in breast cancer at a single institution: role of fractionation and treatment volume","volume":"3","author":"Parekh","year":"2018","journal-title":"Adv Radiat Oncol"},{"key":"2026050118214114900_tqag003-B38","doi-asserted-by":"publisher","first-page":"1017435","DOI":"10.3389\/fonc.2022.1017435","article-title":"Prediction of radiation-induced acute skin toxicity in breast cancer patients using data encapsulation screening and dose-gradient-based multi-region radiomics technique: a multicenter study","volume":"12","author":"Feng","year":"2022","journal-title":"Front Oncol"}],"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag003\/66313632\/tqag003.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1181\/886\/66313632\/tqag003.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1181\/886\/66313632\/tqag003.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:21:47Z","timestamp":1777674107000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/99\/1181\/886\/8417667"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":38,"journal-issue":{"issue":"1181","published-online":{"date-parts":[[2026,1,8]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqag003","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,1,8]]}}}