Radiation-induced lung injury: current evidence

Area of Science:

• Oncology
• Pulmonology
• Radiotherapy

Background:

• Chemo-radiotherapy and systemic therapies are standard for thoracic malignancies but can cause severe pulmonary toxicity.
• Pneumonitis, a serious adverse effect, arises from direct cytotoxic effects, oxidative stress, and immune responses.
• Radiation-Induced Lung Injury (RILI) includes early Radiation Pneumonitis (RP) and late Radiation Fibrosis (RF).

Purpose of the Study:

• To review the clinicopathological features of pneumonitis.
• To provide clinical recommendations for the prevention, diagnosis, and management of pneumonitis.
• To highlight the importance of pulmonary function tests and standardized corticosteroid use.

Main Methods:

• Literature review of clinicopathological features of pneumonitis.
• Analysis of diagnostic approaches including clinical assessment, radiological findings, and pulmonary function tests.
• Evaluation of current management strategies, including systemic corticosteroids.

Main Results:

• Pneumonitis diagnosis is currently based on exclusion, combining clinical and radiological data.
• Pulmonary function tests are crucial for assessing lung function and predicting complications.
• Systemic corticosteroids are used for treatment, but standardized prophylactic use needs consideration.

Conclusions:

• Effective prevention, diagnosis, and management strategies are essential for mitigating pneumonitis.
• Standardization of corticosteroid use in prophylaxis and treatment is recommended.
• Further research into predictive tools and standardized protocols can improve patient outcomes.