Radiation-induced lung injury

Marks, Lawrence B; Yu, Xiaoli; Vujaskovic, Zjelko; Small, William; Folz, Rodney; Anscher, Mitchell S

doi:10.1016/S1053-4296(03)00034-1

« Previous Next »Seminars in Radiation Oncology
Volume 13, Issue 3 , Pages 333-345, July 2003

Radiation-induced lung injury☆

Lawrence B Marks
- Address reprint requests to Lawrence B. Marks, MD, Department of Radiation Oncology, Box 3085, Duke University Medical Center, Durham, NC 27710, USA
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
Xiaoli Yu
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
Zjelko Vujaskovic
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
William Small Jr
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
Rodney Folz
- Department of Medicine, Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC, USA
Mitchell S Anscher
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA

Abstract

Radiation therapy (RT) for thoracic-region tumors often causes lung injury. The incidence of lung toxicity depends on the method of assessment (eg, radiographs, patient’s symptoms, or functional endpoints such as pulmonary function tests). Three-dimensional (3D) treatment planning tools provide dosimetric predictors for the risk of symptomatic RT-induced lung injury and allow for beams to be selected to minimize these risks. A variety of cytokines have been implicated as indicators/mediators of lung injury. Recent work suggests that injury-associated tissue hypoxia perpetuates further injury. Sophisticated planning/delivery methods, such as intensity modulation, plus radioprotectors such as amifostine, hold promise to reduce the incidence of RT-induced lung injury.