Radiation-Induced Lung Injury-Current Perspectives and Management

Authors

Mandeep Singh Rahi, Division of Pulmonary Diseases and Critical Care, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Jay Parekh, Department of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Prachi Pednekar, Department of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Gaurav Parmar, Department of Radiology, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Soniya Abraham, Department of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Samar Nasir, Department of Internal Medicine, University at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA.
Rajamurugan Subramaniyam, Department of Pulmonary Critical Care Medicine, St. Louis University, 3635 Vista Ave, St. Louis, MO 63110, USA.
Gini Priyadharshini Jeyashanmugaraja, Department of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Kulothungan Gunasekaran, Division of Pulmonary Diseases and Critical Care, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.

Document Type

Article

Publication Title

Clinics and practice

Abstract

Radiotherapy plays an important role in the treatment of localized primary malignancies involving the chest wall or intrathoracic malignancies. Secondary effects of radiotherapy on the lung result in radiation-induced lung disease. The phases of lung injury from radiation range from acute pneumonitis to chronic pulmonary fibrosis. Radiation pneumonitis is a clinical diagnosis based on the history of radiation, imaging findings, and the presence of classic symptoms after exclusion of infection, pulmonary embolism, heart failure, drug-induced pneumonitis, and progression of the primary tumor. Computed tomography (CT) is the preferred imaging modality as it provides a better picture of parenchymal changes. Lung biopsy is rarely required for the diagnosis. Treatment is necessary only for symptomatic patients. Mild symptoms can be treated with inhaled steroids while subacute to moderate symptoms with impaired lung function require oral corticosteroids. Patients who do not tolerate or are refractory to steroids can be considered for treatment with immunosuppressive agents such as azathioprine and cyclosporine. Improvements in radiation technique, as well as early diagnosis and appropriate treatment with high-dose steroids, will lead to lower rates of pneumonitis and an overall good prognosis.

First Page

410

Last Page

429

DOI

10.3390/clinpract11030056

Publication Date

7-1-2021

Recommended Citation

Rahi, Mandeep Singh; Parekh, Jay; Pednekar, Prachi; Parmar, Gaurav; Abraham, Soniya; Nasir, Samar; Subramaniyam, Rajamurugan; Jeyashanmugaraja, Gini Priyadharshini; and Gunasekaran, Kulothungan, "Radiation-Induced Lung Injury-Current Perspectives and Management" (2021). Internal Medicine. 189.
https://scholar.bridgeporthospital.org/internal_medicine/189

Identifier

34287252 (pubmed); PMC8293129 (pmc); 10.3390/clinpract11030056 (doi); clinpract11030056 (pii)