{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:52:02Z","timestamp":1782219122685,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate associations between lung dose and symptomatic pneumonitis in five\u2010fraction breast radiotherapy and identify strategies to limit lung exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Materials<\/jats:title>\n                    <jats:p>\n                      We retrospectively analysed 224 consecutive patients with early\u2010stage breast cancer treated between 2020 and 2024 at a single institution using five\u2010fraction adjuvant radiotherapy, including whole\u2010breast radiotherapy (WBRT [\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009157]: 26\u2009Gy [5.2\u2009Gy daily] or 28.5\u2009Gy [5.7\u2009Gy weekly]) and accelerated partial\u2010breast irradiation (APBI [\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200967]: 30\u2009Gy [6\u2009Gy every other day]). Associations between lung dose\u2010volume parameters and symptomatic pneumonitis were examined, along with potential dose thresholds linked to increased risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a median follow\u2010up of 13\u2009months, 8 patients (3.6%) developed symptomatic (grade \u2265\u20092) pneumonitis. Symptoms were mostly mild and self\u2010limited, with only one patient experiencing grade 3 pneumonitis. Pneumonitis risk showed a dose\u2013response pattern: Each 1% increase in ipsilateral lung volume receiving 8\u2009Gy, 10\u2009Gy, and 20\u2009Gy was associated with relative risk increases of 13%, 23%, and 33%, respectively (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). An exploratory threshold of V20Gy \u2265\u20097.5% identified a subgroup of patients at higher risk, with pneumonitis rates of 9.0% (7\/78) above this threshold compared to 0.7% (1\/146) for those below (AUC 0.79). In patients receiving WBRT, prone positioning reduced lung V20Gy. APBI was also associated with lower lung V20Gy (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although mild and self\u2010limited, the risk of symptomatic pneumonitis progressively increased with higher fractional lung doses during five\u2010fraction breast radiotherapy. APBI or prone positioning for WBRT may help reduce intermediate\u2010to\u2010high lung dose volumes (such as V20Gy) and pneumonitis risk in eligible patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70140","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:13:55Z","timestamp":1782216835000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung Dose and Pneumonitis Risk Following Five\u2010Fraction Breast Radiotherapy"],"prefix":"10.1111","author":[{"given":"Kristin A.","family":"Ward","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Case","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela","family":"Hanasoge","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mylin A.","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5660-6365","authenticated-orcid":false,"given":"Jolinta Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather G.","family":"Gatcombe","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohini K.","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie A.","family":"Ridge","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen D.","family":"Godette","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Jagsi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-6569","authenticated-orcid":false,"given":"Sunil W.","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta GA 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