Clinical Features for Radiation Pneumonitis

 

Clinical features:

(1) The patient develops respiratory symptoms 1-6 months after radiation therapy.

(2) The patient presents with the insidious onset of:

(2a) dyspnea

(2b) dry cough

(2c) low-grade fever

(2d) chest fullness, discomfort or pain

(2e) weight loss

(2f) malaise and fatigue

(3) The physical examination may be negative or may show skin erythema, rales and/or a pleural friction rub.

(4) positive response to corticosteroids

 

Imaging studies (changes better seen with CT scan):

(1) ill-defined perihilar infiltrates (corresponding to areas of congestion and acute alveolar injury)

(2) straight-edged parenchymal opacities corresponding to the radiation port

(3) traction bronchiectasis

 

Exclusions:

(1) infection

(2) progression of underlying cancer

(3) asthma or allergy

(4) drug-induced toxicity

 

Complications:

(1) pulmonary fibrosis (develops 6-24 months after the radiation therapy)

(2) pulmonary hypertension