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.
aDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
bRobert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
cDepartment of Medicine, Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC, USA
Address reprint requests to Lawrence B. Marks, MD, Department of Radiation Oncology, Box 3085, Duke University Medical Center, Durham, NC 27710, USA
☆ Supported in part by NCI Grants CA69579 and CA83721 and NIH Grant 21CA83721.
ABSTRACT