(Radiation-induced Lung Injury)
Radiation pneumonitis is an inflammation of the lung tissue. It often appears between 6 and 24 weeks after radiation therapy.
If left untreated, pneumonitis can lead to lasting lung or breathing problems.
Radiation pneumonitis is most often caused by radiation therapy to the lungs or nearby areas.
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This condition is most common in people who have radiation therapy for lung cancer. It is also more common in older adults. Other things that raise the risk of radiation pneumonitis are:
Radiation pneumonitis does not always cause symptoms. When symptoms happen, breathing problems are the most common. They may happen with activity or rest and get worse over time.
Other symptoms may be:
- Lasting dry cough, which may range from mild to severe
- Chest pain
- Increasing amounts of sputum, with or without blood
- Muscle aches
- Increasing weakness
The doctor will ask about symptoms, past health, and recent treatment. A physical exam will be done. This includes listening to the lungs. Other conditions need to be ruled out. Tests may include:
- Blood tests—to look for signs of infection or imbalances
- Pulmonary function tests —to assess function of the lungs
- Swabs to test secretions in the throat—to look for infection
- Sputum culture—to look for infection
Imaging tests to view the lungs and surrounding structures are:
When caught early, the goal is to stop inflammation before it causes harm. Treatment depends on the severity of the radiation pneumonitis. Prompt treatment may lead to a full recovery in most people.
Treatment may include:
- Corticosteroids to reduce lung inflammation
- Medicines to suppress the immune system
Other treatments may help ease symptoms until pneumonitis is healed. Options are:
- Vitamin A, C, and E supplements
- Cough medicines
- Oxygen therapy to increase the amount of available oxygen
Some medicines or chemotherapy drugs can make pneumonitis worse. These treatments may need to be stopped or changed.
Lung function will also be checked regularly to look for changes.
Radiation is carefully measured. The goal is to give the least but most effective amount to the smallest area of tissue.
Finding and treating symptoms early leads to better outcomes. It is important to monitor any side effects from radiation therapy.
- Hanania AN, Mainwaring W, et al. Radiation-induced lung injury: assessment and management. Chest. 2019;156(1):150-162.
- Radiation exposure and contamination. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/injuries-poisoning/radiation-exposure-and-contamination/radiation-exposure-and-contamination.
- Radiation-induced lung injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/radiation-induced-lung-injury.
- Radiation pneumonitis. Oncolink website. Available at: https://www.oncolink.org/cancer-treatment/radiation/side-effects-of-radiation-therapy/radiation-pneumonitis.
- Radiation therapy. American Cancer Society website. Available at:https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation.html.
- Mohei Abouzied, MD, FACP
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