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RADIATION-INDUCED LUNG INJURY
Strategies for reducing damage while optimizing therapeutic dosage

Ericka Wiebe, MSc and George Rodrigues MD, FRCPC, MSc

Thoracic radiation is commonly employed to treat lung, esophageal, breast and lymphoma cancers. Lung inflammation caused by radiation therapy, called radiation pneumonitis (RP), is the most common dose-limiting complication of thoracic radiation.

 

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Top-line summary
Therapeutic radiation aims to achieve locoregional control of malignancy while minimizing acute and long-term adverse effects of radiation therapy. Safe administration of therapeutic radiation demands knowledge of both tumour and normal tissue response to radiation. Normal tissue tolerance depends on the tissue’s intrinsic radiosensitivity, the dose-volume relationship (i.e. the percentage of organ volume receiving a specified dose) and modifying factors such as radiosensitizing chemotherapy. Use of tumour and/or patient immobilization, 3-dimensional computerized tomography (3D CT) planning and advanced radiation delivery techniques have all contributed to reductions in the dose administered to nontumour critical structures. Here, Oncology Exchange reviews the pathology and incidence of radiation damage to the lungs associated with thoracic radiation, describes new technologies that are continually improving the therapeutic ratio by maximizing dose to the target while minimizing treatment toxicity, and discusses treatments available and/or under investigation to treat radiation damage when it does occur.
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