Non-small cell lung cancer therapy-related pulmonary toxicity

An update on radiation pneumonitis and fibrosis

Feng Ming Kong, Randall Ten Haken, Avraham Eisbruch, Theodore S. Lawrence

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Successful treatment of non-small cell lung cancer requires adequate local and systemic disease control. Although it has been shown to have superior results, high-dose radiation therapy is not a current practice largely because of concerns of normal tissue toxicity. This article reviews and updates the possible mechanism of radiation-induced pneumonitis and fibrosis, their associations with dose intensity, and the role they may play in making treatment decisions. The commonly used clinical terminology and grading systems are summarized. Pneumonitis and fibrosis after 3-dimensional conformal high-dose radiation are reviewed, including recent updates from radiation dose escalation trials. Chemotherapy- and chemoradiation-related lung toxicities are also discussed. Individual susceptibility and potential predictive models are examined; dose and 3-dimensional dosimetric parameters are reviewed along with estimation of normal tissue complication probability and biologic predictive assays. Based on the risk levels of toxicity for each patient, future clinical trials may be designed to maximize individual therapeutic gain.

Original languageEnglish (US)
Pages (from-to)42-54
Number of pages13
JournalSeminars in Oncology
Volume32
Issue numberSUPPL. 3
DOIs
StatePublished - Jan 1 2005

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Radiation Pneumonitis
Non-Small Cell Lung Carcinoma
Lung
Radiation
Terminology
Biological Assay
Pneumonia
Decision Making
Fibrosis
Radiotherapy
Therapeutics
Clinical Trials
Drug Therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Non-small cell lung cancer therapy-related pulmonary toxicity : An update on radiation pneumonitis and fibrosis. / Kong, Feng Ming; Ten Haken, Randall; Eisbruch, Avraham; Lawrence, Theodore S.

In: Seminars in Oncology, Vol. 32, No. SUPPL. 3, 01.01.2005, p. 42-54.

Research output: Contribution to journalArticle

Kong, Feng Ming ; Ten Haken, Randall ; Eisbruch, Avraham ; Lawrence, Theodore S. / Non-small cell lung cancer therapy-related pulmonary toxicity : An update on radiation pneumonitis and fibrosis. In: Seminars in Oncology. 2005 ; Vol. 32, No. SUPPL. 3. pp. 42-54.
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