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Radiation Pneumonitis (Radiation Fibrosis)

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Inflammation of the lung due to harmful effects of ionizing or non-ionizing radiation.

Also Known As:

Radiation Fibrosis; Fibrosis, Radiation; Radiation Pneumonia; Pneumonias, Radiation; Pneumonitides, Radiation; Radiation Pneumonias; Radiation Pneumonitides; Pneumonia, Radiation; Pneumonitis, Radiation

Networked: 509 relevant articles (21 outcomes, 50 trials/studies)

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Disease Context: Research Results

Related Diseases

1.	Fibrosis (Cirrhosis)
2.	Radiation Pneumonitis (Radiation Fibrosis)
3.	Residual Neoplasm
4.	Necrosis
5.	Dyspnea (Shortness of Breath)

Experts

1.	Liao, Zhongxing: 9 articles (05/2014 - 07/2007)
2.	Guerrero, Thomas: 7 articles (01/2014 - 07/2007)
3.	Bentzen, Søren M: 6 articles (05/2014 - 10/2010)
4.	Wei, Qingyi: 6 articles (12/2013 - 07/2009)
5.	Komaki, Ritsuko: 6 articles (09/2013 - 07/2007)
6.	Senan, Suresh: 5 articles (09/2015 - 01/2004)
7.	Wang, Li-E: 5 articles (04/2013 - 07/2009)
8.	Farr, Katherina P: 4 articles (10/2015 - 05/2014)
9.	Khalil, Azza A: 4 articles (10/2015 - 05/2014)
10.	Castillo, Richard: 4 articles (06/2015 - 07/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Radiation Pneumonitis:

1.	Adrenal Cortex Hormones (Corticosteroids)IBA 04/17/1999 - "The two types of radiation pneumonitis can be treated successfully with corticosteroids. " 09/01/1991 - "Corticosteroids have previously been found to be protective against the mortality of radiation pneumonitis in mice, even when given well after lethal lung irradiation. " 01/01/2013 - "In a patient with locally advanced NSCLC that progressed despite chemoradiation, radiation pneumonitis and subsequently cavitary disease developed following the administration of corticosteroids. " 09/01/2006 - "Grade 3-4 radiation pneumonitis occurred in two patients (7.7%) and was treated with corticosteroids. " 05/01/2003 - "Radiation pneumonitis successfully treated with inhaled corticosteroids."
2.	erlotinib (CP 358,774)FDA Link 10/01/2011 - "Exacerbation of radiation fibrosis with erlotinib: another pattern of radiation recall phenomenon." 07/01/2009 - "This case had radiation fibrosis, so we suggest that radiation fibrosis may be another contributor of the occurrence of ILD in patients taking erlotinib." 07/01/2009 - "We recently experienced a case of fatal erlotinib-induced ILD, diagnosed based on clinical and radiologic findings, which occurred in a patient with radiation fibrosis. " 06/01/2014 - "Radiation pneumonitis should be considered in patients treated with concurrent thoracic radiotherapy and erlotinib." 01/01/2014 - "Special attention should be paid to the adverse effects of radiation pneumonitis in concurrent thoracic radiotherapy and erlotinib treatment. "
3.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 03/01/2001 - "In contrast, we did not detect a significant correlation between plasma TNFalpha and radiation pneumonitis. " 10/01/2011 - "The reduced level of radiation pneumonitis (as monitored by breathing rate changes) in animals knocked out for TNF-alpha suggests that this cytokine plays a significant role in inducing inflammation in lung following irradiation. " 12/01/2007 - "Plasma level of TNF-alpha and ratio of IL-10/ TNF-a could be the practicable indexes for estimating the susceptibility of acute radiation pneumonia; SFI can regulate the network of cytokine, and thus be effective in preventing and treating radiation pneumonitis." 07/01/2005 - "At the onset of radiation fibrosis in C57BL/6J mice (5-6 months), irradiated lungs had increased levels of IL-1alpha/beta and IFN-gamma mRNA expression, but the TNF-alpha response was, notably, still muted. " 12/01/2005 - "The most serious acute radiation pneumonia was seen in the 5th week and pulmonary fibrosis was remarkable in the 26th week in the simple irradiation group, with the expressions of TNF-alpha and TGF-beta at different time phases enhanced significantly (P < 0.01). "
4.	Pentoxifylline (Trental)FDA LinkGeneric 08/15/2010 - "Radiation pneumonitis is treated with oral prednisone and pentoxifylline. " 06/01/2005 - "Pilot studies testing alpha-tocopherol and pentoxifylline provide evidence of clinical regression of superficial radiation fibrosis after radiotherapy. " 04/01/2015 - "To review the conservative and surgical management options of osteoradionecrosis, in particular, highlighting the recent the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate). " 12/01/2012 - "Clinical therapeutic interventions for radiation fibrosis have included empirical treatments, such as antioxidant therapies using superoxide dismutase, or vitamin E and pentoxifylline, and although evidence for therapeutic efficacy exists, further randomised studies are required. " 04/01/2015 - "Over the years several treatment options have been proposed including; conservative management (antibiotics, analgesics, oral hygiene), ultrasound therapy, hyperbaric oxygen therapy, surgical resection with reconstruction and more recently the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate). "
5.	Superoxide DismutaseIBA 08/01/2012 - "To explore serum superoxide dismutase (SOD) for predicting radiation pneumonitis (RP) in non-small cell lung cancer patients following chemoradiotherapy. " 08/01/2012 - "Serum superoxide dismutase, a potential predictor for radiation pneumonitis following chemoradiotherapy in non-small cell lung cancer patients." 01/15/2007 - "High superoxide dismutase and low glutathione peroxidase activities in red blood cells predict susceptibility of lung cancer patients to radiation pneumonitis." 12/01/2012 - "Clinical therapeutic interventions for radiation fibrosis have included empirical treatments, such as antioxidant therapies using superoxide dismutase, or vitamin E and pentoxifylline, and although evidence for therapeutic efficacy exists, further randomised studies are required. " 09/01/2005 - "Several medications have also been evaluated for their ability to reduce radiation pneumonitis in animals and humans, including corticosteroids, amifostine, ACE inhibitors or angiotensin II type 1 receptor blockers, pentoxifylline, melatonin, carvedilol, and manganese superoxide dismutase-plasmid/liposome. "
6.	Captopril (Capoten)FDA LinkGeneric 07/01/1993 - "Histological examination of the irradiated lungs indicated that these acute changes detected by CT were associated with the exudative and edematous phases of radiation pneumonitis, and that captopril reduced the severity of these changes. " 07/01/2012 - "In the current study we determined the dose modifying factors (DMFs) of captopril for mitigation of parameters of radiation pneumonitis. " 12/01/1990 - "These data are the first to demonstrate that the ACE inhibitor captopril might provide a novel intervention in the pathogenesis of radiation fibrosis." 07/01/1993 - "Radiation pneumonitis in rats and its modification by the angiotensin-converting enzyme inhibitor captopril evaluated by high-resolution computed tomography."
7.	Octreotide (Sandostatin)FDA LinkGeneric 04/01/2001 - "Octreotide confers dose-dependent protection against delayed small bowel radiation toxicity and ameliorates radiation fibrosis predominantly by reducing acute mucosal injury. " 04/01/2001 - "The present study addressed whether octreotide reduces chronic intestinal radiation fibrosis, whether enteroprotection is conferred by direct or indirect mechanisms, and whether the effects are dose-dependent. " 01/01/2008 - "Increased activity on In-111 octreotide imaging due to radiation fibrosis."
8.	Vitamin E FDA LinkGeneric 12/01/2012 - "Clinical therapeutic interventions for radiation fibrosis have included empirical treatments, such as antioxidant therapies using superoxide dismutase, or vitamin E and pentoxifylline, and although evidence for therapeutic efficacy exists, further randomised studies are required. "
9.	CollagenIBA 05/01/1990 - "(3) Finally, during radiation fibrosis T1 shortened and collagen increased. " 12/01/1986 - "However, despite detailed work on collagen metabolism, the pathogenesis of radiation fibrosis remains unknown. " 12/01/1998 - "MR1 protected against death from radiation pneumonitis and fibrosis and dramatically reduced lung pathology as evidenced by a limited influx of inflammatory cells, minimal collagen deposition, and septal thickening. " 01/01/2010 - "Interstitial lung diseases (ILDs) include more than 200 disease entities such as drug induced ILD, radiation pneumonitis, collagen vascular disease-associated interstitial pneumonia, and idiopathic interstitial pneumonias (IIPs). " 08/01/1999 - "The serum level of KL-6/MUC1 was elevated in 70-100% of patients with interstitial pneumonitis, such as pulmonary fibrosis (either idiopathic or related to collagen-vascular disorders), hypersensitivity pneumonitis, sarcoidosis, and radiation pneumonitis. "
10.	gemcitabine FDA Link 07/01/2012 - "In multivariate logistic regression analysis, the occurrence of acute radiation pneumonitis was significantly associated with age above 75 years (odds ratio [OR]=16.72 ; P=0.02) and with administration of neoadjuvant gemcitabine (OR=18.08, P=0.04). " 01/01/2014 - "Improved survival benefit was observed in patients who have received three or more cycles of full dose adjuvant chemotherapy, yet, gemcitabine related radiation pneumonitis and hematological toxicities limited adjuvant chemotherapy delivery." 07/01/2003 - "Dose-limiting toxicity was grade 3 esophagitis and grade 3 radiation pneumonitis in the patient cohort receiving gemcitabine 450 mg/m(2) once weekly. " 07/01/2009 - "High frequency of radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent radiotherapy and gemcitabine after induction with gemcitabine and carboplatin."

Therapies and Procedures

1.	Radiotherapy 12/01/2004 - "For the early detection of radiation pneumonitis following breast-conservation surgery, and to assess the efficacy of therapy, the monitoring and measuring of changes in KL-6 levels before and after radiotherapy is more important than comparing KL-6 levels against the threshold value. " 02/01/1985 - "On the low-dose regimen, one patient achieved partial response with IFN alone (duration, 12 weeks); of five evaluable patients three achieved complete remission and two partial remission to IFN-radiotherapy, and one of the three complete responders to IFN-radiotherapy died of severe radiation pneumonitis at 21 weeks from the start of IFN treatment. " 02/01/2006 - "Seventy percent of the patients (16/23) experienced improved perfusion at 40 - 50 Gy. > or = grade 2 radiation pneumonitis was observed in 12 patients (38.7%) in the whole group, with 6 in those with grade 1 perfusion defects and another 6 in > or = grade 2 group, respectively; Of the 23 patients who had had both pre- and post-radiotherapy SPECT perfusion scan, 5 > or = grade 2 radiation pneumonitis occurred in the 16 perfusion-improved patients and 3 in the 7 unimproved patients. " 01/01/2014 - "In the present study, we investigate whether there are relationships between the expressions of TLRs and the occurrence of radiation pneumonia in advanced NSCLC patients treated with radiotherapy. " 01/01/2013 - "Electronic databases, reference sections of major oncological textbooks and identified studies were searched for synonyms of breast radiotherapy and radiation pneumonitis (RP). "
2.	Drug Therapy (Chemotherapy) 11/01/2012 - "Studies reporting crude incidence or odds ratios (OR) for radiation pneumonitis vs. age, disease location, smoking status, chemotherapy schedule or comorbidity were included. " 09/01/2011 - "This study compared radiation therapy (RT) plans based on pre- and postchemotherapy computed tomography (CT) scans of patients with SCLC to estimate the reduced risk of radiation pneumonitis (RP) after receiving chemotherapy. " 07/01/2010 - "Some studies demonstrated that preexisting pulmonary lung dysfunction, tumour location in lower lobes, use of concurrent chemotherapy could increase the risk of radiation pneumonitis. " 09/01/2005 - "chemotherapy regimen and dose) have been proposed as potential predictors of the risk of radiation pneumonitis, but these have not been consistently demonstrated across different studies. " 01/01/1997 - "However, future studies using protracted radiosensitizing chemotherapy should be approached cautiously in light of the high incidence of severe radiation pneumonitis encountered in this trial."
3.	Brachytherapy 01/01/2003 - "In the latter case, reirradiation, generally with endobronchial brachytherapy, was successful in palliation of intrathoracic symptoms (in at least two-thirds of cases), carrying a low incidence of radiation pneumonitis (up to 5%) although cumulative doses went up to 120-150 Gy. Besides external beam RT, endobronchial RT was used to treat symptomatic intraluminal recurrences, with the vast majority of studies using high-dose rate brachytherapy. " 09/01/2008 - "To the best of our knowledge, this is the first report of radiation pneumonitis caused by a migrated brachytherapy seed in the lung." 09/01/2008 - "We report a case of radiation pneumonitis caused by a migrated seed lodged in the lung after prostate brachytherapy. " 09/01/2008 - "Radiation pneumonitis caused by a migrated brachytherapy seed lodged in the lung." 11/01/1996 - "For 13 patients conventional salvage by partial debulking surgery and brachytherapy proved effective, with 68 per cent control at 1 year, but six patients suffered severe radiation fibrosis, necrosis and contractures. "
4.	Aftercare (After-Treatment) 08/01/2013 - "Clinical radiation pneumonitis was not found to be a significant complication, and no patient required steroid therapy after treatment for radiation pneumonitis. " 09/01/2009 - "Early CT findings of tomotherapy-induced radiation pneumonitis after treatment of lung malignancy." 06/01/2003 - "Twelve patients developed radiation pneumonitis, 8 Grade 1, 2 Grade 2, 1 Grade 3, and 1 Grade 4. In patients who developed radiation pneumonitis, the clearance t1/2 for the diseased lung decreased from 37.50 min to 29.00 min after treatment (p = 0.50). " 05/01/1991 - "The severity of radiation fibrosis was assessed clinically from CT scans 6 months and 12 months after treatment. " 12/01/1988 - "[Lung tissue volume changes before and after treatment of radiation pneumonitis]."
5.	Adjuvant Chemotherapy 04/01/1980 - "A patient with Hodgkin's disease developed acute radiation pneumonia four months after completion of mantle radiotherapy and during cyclical adjuvant chemotherapy. " 01/01/2014 - "Improved survival benefit was observed in patients who have received three or more cycles of full dose adjuvant chemotherapy, yet, gemcitabine related radiation pneumonitis and hematological toxicities limited adjuvant chemotherapy delivery."