Radiation pneumonitis: Experience following a single treatment

Abstract

The acute radiation pneumonitis syndrome of increasing cough with dyspnoea and characteristic radiographic changes developed in 44 of 245 patients (17.5%) treated with a single large dose of radiation. The median onset was 100 days and proved fatal in 84 percent of cases within two weeks. Because these patients with advanced cancer had a median survival of 126 days the incidence was calculated by the actuarial method. This was 83.5 and 29 percent for single uncorrected doses of 1,000 and 800 rad: the two standard deviations were 20 and 14 percent. The risk increased with previous irradiation or intrathoracic tumor. Steroids had no obvious protective effect, but in three patients withdrawal of the drug apparently precipitated the syndrome. Vigorous supportive treatment with antibiotics and prednisone reversed the process in three cases, Radiotolerance of the lung is the limiting factor in usirgradiation as a systemic treatment for cancer.