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Treatment for early breast cancer is multimodal with radiotherapy playing a fundamental role. This study investigated the relationship between the depth of lung incorporated in the tangential chest wall fields and self-reported respiratory symptoms. A randomised trial was conducted with 350 patients from one radiotherapy centre, randomised to one of two lung depth categories (0-2 cm or 0-2.5 cm). The primary outcome measure was the self-reported incidence of dry unproductive cough (DUC) post-treatment. On an intention to treat basis no difference in post-treatment symptoms for DUC could be identified between the two lung depth categories. A logistic regression analysis identified patient age, the use of nodal irradiation, and symptoms of DUC pre-treatment as significant in determining the risk of patients developing symptoms post-treatment. These results confirm the importance of considering total volume of lung incorporated in the radiotherapy portals (identified by the relationship between reported symptoms and the use of nodal irradiation). The results of this study serve to further emphasise the need for evidence-based study into the radiotherapy policies employed in the UK. © 2004 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

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