Abstract
Radiation pneumonitis is a well-described complication of chest radiotherapy administered to patients for mediastinal, breast, and lung tumors. Dyspnea, cough, and radiographic infiltrates within the field of radiation are typical symptoms and findings. Systemic corticosteroids are the traditionally accepted treatment, often with good clinical responses reported in a large number of patients. However, no randomized controlled trials exist to support their use. Inhaled steroids have been the mainstay in asthma treatment and have been used to reduce side effects of systemic corticosteroids. Inhaled steroids are being used on an increasing basis to treat other steroid responsive lung diseases such as sarcoidosis. This case report shows inhaled steroids being successfully used to treat radiation pneumonitis.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References 1. Groover TA, Christie AC, Merritt EA. Observations on the use of the copper filter in the treatment of deep-seated malignancies. South Med J 1922; 15: 440–444.GrooverTA]]ChristieAC]]MerrittEAObservations on the use of the copper filter in the treatment of deep-seated malignanciesSouth Med J192215440 2. Movsas B, Raffin TA, Epstein AH, Link CJ Jr. Pulmonary radiation injury. Chest 1997; 111: 1061–1076.MovsasB]]RaffinTA]]EpsteinAH]]LinkCJPulmonary radiation injuryChest19971111061 3. Gross NJ. Pulmonary effects of radiation therapy. Ann Intern Med 1977; 129: 127–136.GrossNJPulmonary effects of radiation therapyAnn Intern Med1977129127 4. Roach M III, Gandara DR, Yuo HS, Swift PS, Kroll S, Shrieve DC, et al. Radiation pneumonitis following combined modality therapy for lung cancer: Analysis of prognostic factors. J Clin Oncol 1995; 13: 2606–2612.RoachM]]GandaraDR]]YuoHS]]SwiftPS]]KrollS]]ShrieveDCRadiation pneumonitis following combined modality therapy for lung cancer: Analysis of prognostic factorsJ Clin Oncol1995132606 5. Inoue A, Kunitoh H, Sekine I, Sumi M, Tokuuye K, Saijo N. Radiation pneumonitis in lung cancer patients: A retrospective study of risk factors and the long-term prognosis. Int J Radiat Oncol Biol Phys 2001; 49: 649–655.InoueA]]KunitohH]]SekineI]]SumiM]]TokuuyeK]]SaijoNRadiation pneumonitis in lung cancer patients: A retrospective study of risk factors and the long-term prognosisInt J Radiat Oncol Biol Phys200149649 6. Libshitz HI, Southard ME. Complications of radiation therapy: The thorax. Semin Roentgenol 1974; 9: 41–49.LibshitzHI]]SouthardMEComplications of radiation therapy: The thoraxSemin Roentgenol1974941 7. Rosiello, RA, Merrill, WW. Radiation-induced lung injury. Clin Chest Med 1990; 11: 65–71.RosielloRA]]MerrillWWRadiation-induced lung injuryClin Chest Med19901165 8. Morgan GW, Breit SN. Radiation and the lung: A reevaluation of the mechanisms mediating pulmonary injury. Int J Radiat Oncol Biol Phys 1995; 31: 361–369.MorganGW]]BreitSNRadiation and the lung: A reevaluation of the mechanisms mediating pulmonary injuryInt J Radiat Oncol Biol Phys199531361 9. Arbetter KR, Prakash UB, Tazelaar HD, Douglas WW. Radiation-induced pneumonitis in the “nonirradiated” lung. Mayo Clin Proc 1999; 74: 27–36.ArbetterKR]]PrakashUB]]TazelaarHD]]DouglasWWRadiation-induced pneumonitis in the “nonirradiated” lungMayo Clin Proc19997427 10. Roberts CM, Foulcher E, Zaunders JJ, Bryant DH, Freund J, Cairns D, et al. Radiation pneumonitis: A possible lymphocyte-mediated hypersensitivity reaction. Ann Intern Med 1993; 118: 696–700.RobertsCM]]FoulcherE]]ZaundersJJ]]BryantDH]]FreundJ]]CairnsDRadiation pneumonitis: A possible lymphocyte-mediated hypersensitivity reactionAnn Intern Med1993118696 11. Martin C, Romero S, Sanchez-Paya J, Massuti B, Arriero JM, Hernandez L. Bilateral lymphocytic alveolitis: A common reaction after unilateral thoracic irradiation. Eur Respir J 1999; 13: 727–732.MartinC]]RomeroS]]Sanchez-PayaJ]]MassutiB]]ArrieroJM]]HernandezLBilateral lymphocytic alveolitis: A common reaction after unilateral thoracic irradiationEur Respir J199913727 12. Prakash U. Radiation-induced injury in the “nonirradiated” lung. Eur Respir J 1999; 13: 715–717.PrakashURadiation-induced injury in the “nonirradiated” lungEur Respir J199913715 13. Pagel J, Mohorn M, Kloetzer KH, Fleck M, Wendt TG. The inhalation versus systemic prevention of pneumonitis during thoracic irradiation. Strahlenther Onkol 1998; 174: 25–29.PagelJ]]MohornM]]KloetzerKH]]FleckM]]WendtTGThe inhalation versus systemic prevention of pneumonitis during thoracic irradiationStrahlenther Onkol199817425 14. Delanian S, Balla-Mekias S, Lefaiz J. Striking regression of chronic radiotherapy damage in a clinical trial of combined pentoxifylline and tocopherol. J Clin Oncol 1999; 17: 3283–3290.DelanianS]]Balla-MekiasS]]LefaizJStriking regression of chronic radiotherapy damage in a clinical trial of combined pentoxifylline and tocopherolJ Clin Oncol1999173283 15. Molteni A, Moulder JE, Cohen EF, Ward WF, Fish BL, Taylor JM, et al. Control of radiation-induced pneumopathy and lung fibrosis by angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blocker. Int J Radiat Biol 2000; 76: 523–532.MolteniA]]MoulderJE]]CohenEF]]WardWF]]FishBL]]TaylorJMControl of radiation-induced pneumopathy and lung fibrosis by angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockerInt J Radiat Biol200076523 16. Paramothayan NS, Jones PW. Corticosteroids for pulmonary sarcoidosis. Cochrane Database Syst Rev 2000; 2: CD001114.ParamothayanNS]]JonesPWCorticosteroids for pulmonary sarcoidosisCochrane Database Syst Rev20002CD001114 &NA; The fragrance always stays In the hand that gives the rose. –Hada Bejar
