Artificial pneumothorax can be used to prevent lung toxicity in chest wall radiotherapy

We report two patients in whom an artificial pneumothorax was induced to reduce the risk of radiation pneumonitis and fibrosis after treatment for chest wall tumours. The procedure was well tolerated; the only complication observed was a single episode of syncope following over-inflation. High doses of radiation were given to large chest wall fields with no clinical or radiological evidence of pneumonitis or fibrosis, either during or after treatment. The available literature on the use of artificial pneumothorax with radiation is reviewed, and the technique of induction is described.