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Radiation Pneumonitis

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https://www.readbyqxmd.com/read/29927195/fibrotic-lung-toxicity-induced-by-cytotoxic-drugs-radiation-and-immunotherapy-in-patients-treated-for-lung-cancer
#1
Elena Bargagli, Viola Bonti, Alessandra Bindi, Vieri Scotti, Massimo Pistolesi, Luca Voltolini, Katia Ferrari
Patients treated for lung cancer may develop lung toxicity induced by chemotherapy (DILD), radiation or combined radiation recall pneumonitis. In the literature, some cases of immune-mediated pneumonitis have been reported associated with immunotherapy. The clinical and radiologic features of interstitial lung toxicity are unspecific, dyspnoea and dry cough are the most common symptoms while the most frequent radiological pattern is the cryptogenic organizing pneumonia (COP). Why only some individuals treated with these drugs develop interstitial lung toxicity is unclear...
June 21, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29904808/the-value-of-99m-tc-maa-spect-ct-for-lung-shunt-estimation-in-90-y-radioembolization-a-phantom-and-patient-study
#2
Jonathan D Allred, Jeremy Niedbala, Justin K Mikell, Dawn Owen, Kirk A Frey, Yuni K Dewaraja
BACKGROUND: A major toxicity concern in radioembolization therapy of hepatic malignancies is radiation-induced pneumonitis and sclerosis due to hepatopulmonary shunting of 90 Y microspheres. Currently, 99m Tc macroaggregated albumin (99m Tc-MAA) imaging is used to estimate the lung shunt fraction (LSF) prior to treatment. The aim of this study was to evaluate the accuracy/precision of LSF estimated from 99m Tc planar and SPECT/CT phantom imaging, and within this context, to compare the corresponding LSF and lung-absorbed dose values from 99m Tc-MAA patient studies...
June 15, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29889031/i-131-radiation-induced-myelosuppression-in-differentiated-thyroid-cancer-therapy
#3
Stephan Probst, Gad Abikhzer, Guillaume Chaussé, Michael Tamilia
Radioactive iodine (RAI) treatment of differentiated thyroid cancer has been used in clinical practice for almost 60 years and is generally accepted to be a safe and efficacious treatment. Severe toxicity in the form of radiation pneumonitis, sometimes progressing to fibrosis, and bone marrow suppression are reported but remain rare. We present a case of severe myelosuppression requiring hospitalization and transfusion support in an otherwise well, young female patient who had received 175 mCi I-131 for low-volume micronodular lung disease one month prior, with a cumulative lifetime administered activity of 575 mCi...
June 7, 2018: Molecular Imaging and Radionuclide Therapy
https://www.readbyqxmd.com/read/29879078/treatment-rationale-and-design-of-the-spiral-study-a-phase-ii-trial-of-osimertinib-in-elderly-epidermal-growth-factor-receptor-t790m-positive-nonsmall-cell-lung-cancer-patients-who-progressed-during-prior-egfr-tki-treatment
#4
Junji Uchino, Akira Nakao, Nobuyo Tamiya, Yoshiko Kaneko, Tadaaki Yamada, Kenichi Yoshimura, Masaki Fujita, Koichi Takayama
BACKGROUND: Advances in epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment led to research on the mechanism of the resistance have revealed that an occurrence of T790M gene mutation generated in exon 20 of the EGFR gene is associated with approximately 50% to 60% of observed resistance. Osimertinib, a 3rd-generation EGFR-TKI, has been shown to be effective against both EGFR tyrosine kinase inhibitor-sensitizing and T790M resistance mutations. In this study, we prospectively investigate the efficacy and safety of osimertinib in elderly patients aged ≥75 years, with ineffective prior EGFR-TKI treatment or with recurrence of EGFR-TKI mutation-positive or T790M mutation-positive nonsmall-cell lung cancer...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29878849/impact-of-the-ntcp-modeling-on-medical-decision-to-select-eligible-patient-for-proton-therapy-the-usefulness-of-eud-as-an-indicator-to-rank-modern-photon-vs-proton-treatment-plans
#5
Abdulhamid Chaikh, Valentin Calugaru, Pierre-Yves Bondiau, Juliette Thariat, Jacques Balosso
PURPOSE: The aim of this study is to evaluate the impact of normal tissue complication probability (NTCP)-based radiobiological models on the estimated risk for late radiation lung damages. The second goal is to propose a medical decision-making approach to select the eligible patient for particle therapy. MATERIALS AND METHODS: 14 pediatric patients undergoing cranio-spinal irradiation were evaluated. For each patient, two treatment plans were generated using photon and proton therapy with the same dose prescriptions...
June 7, 2018: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/29876311/decision-analytic-modeling-for-the-economic-analysis-of-proton-radiotherapy-for-non-small-cell-lung-cancer
#6
Wade P Smith, Patrick J Richard, Jing Zeng, Smith Apisarnthanarax, Ramesh Rengan, Mark H Phillips
Background: Although proton radiation treatments are more costly than photon/X-ray therapy, they may lower overall treatment costs through reducing rates of severe toxicities and the costly management of those toxicities. To study this issue, we created a decision-model comparing proton vs. X-ray radiotherapy for locally advanced non-small cell lung cancer patients. Methods: An influence diagram was created to model for radiation delivery, associated 6-month pneumonitis/esophagitis rates, and overall costs (radiation plus toxicity costs)...
April 2018: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/29875593/management-of-acquired-bronchopleural-fistula-due-to-chemical-pneumonia
#7
Reddy Ravikanth, Sunil Mathew, Denver Steven Pinto
Bronchopleural fistula (BPF) is a sinus tract between the bronchus and the pleural space that may result from a necrotizing pneumonia/empyema (anaerobic, pyogenic, tuberculous, or fungal), lung neoplasms, and blunt and penetrating lung injuries or may occur as a complication of procedures such as lung biopsy, chest tube drainage, thoracocentesis, or radiation therapy. The diagnosis and management of BPF remain a major therapeutic challenge for clinicians, and the lesion is associated with significant morbidity and mortality...
April 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29868486/clinical-results-of-mean-gtv-dose-optimized-robotic-guided-stereotactic-body-radiation-therapy-for-lung-tumors
#8
Rene Baumann, Mark K H Chan, Florian Pyschny, Susanne Stera, Bettina Malzkuhn, Stefan Wurster, Stefan Huttenlocher, Marcella Szücs, Detlef Imhoff, Christian Keller, Panagiotis Balermpas, Dirk Rades, Claus Rödel, Jürgen Dunst, Guido Hildebrandt, Oliver Blanck
Introduction: We retrospectively evaluated the efficacy and toxicity of gross tumor volume (GTV) mean dose optimized stereotactic body radiation therapy (SBRT) for primary and secondary lung tumors with and without robotic real-time motion compensation. Materials and methods: Between 2011 and 2017, 208 patients were treated with SBRT for 111 primary lung tumors and 163 lung metastases with a median GTV of 8.2 cc (0.3-174.0 cc). Monte Carlo dose optimization was performed prioritizing GTV mean dose at the potential cost of planning target volume (PTV) coverage reduction while adhering to safe normal tissue constraints...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29866342/evaluation-of-functionally-weighted-dose-volume-parameters-for-thoracic-stereotactic-ablative-radiotherapy-sabr-using-ct-ventilation
#9
Takayuki Kanai, Noriyuki Kadoya, Yujiro Nakajima, Yuya Miyasaka, Yoshiro Ieko, Tomohiro Kajikawa, Kengo Ito, Takaya Yamamoto, Suguru Dobashi, Ken Takeda, Kenji Nemoto, Keiichi Jingu
For the purpose of reducing radiation pneumontisis (RP), four-dimensional CT (4DCT)-based ventilation can be used to reduce functionally weighted lung dose. This study aimed to evaluate the functionally weighted dose-volume parameters and to investigate an optimal weighting method to realize effective planning optimization in thoracic stereotactic ablative radiotherapy (SABR). Forty patients treated with SABR were analyzed. Ventilation images were obtained from 4DCT using deformable registration and Hounsfield unit-based calculation...
May 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29862533/a-multi-objective-bayesian-networks-approach-for-joint-prediction-of-tumor-local-control-and-radiation-pneumonitis-in-non-small-cell-lung-cancer-nsclc-for-response-adapted-radiotherapy
#10
Yi Luo, Daniel L McShan, Martha M Matuszak, Dipankar Ray, Theodore S Lawrence, Shruti Jolly, Feng-Ming Kong, Randall K Ten Haken, Issam El Naqa
PURPOSE: Individualization of therapeutic outcomes in NSCLC radiotherapy is likely to be compromised by the lack of proper balance of biophysical factors affecting both tumor local control (LC) and side effects such as radiation pneumonitis (RP), which are likely to be intertwined. Here, we compare the performance of separate and joint outcomes predictions for response-adapted personalized treatment planning. METHODS: 118 NSCLC patients treated on prospective protocols with 32 cases of local progression and 20 cases of RP grade two or higher (RP2) were studied...
June 4, 2018: Medical Physics
https://www.readbyqxmd.com/read/29847598/oral-administration-of-herbal-medicines-for-radiation-pneumonitis-in-lung-cancer-patients-a-systematic-review-and-meta-analysis
#11
Kwan-Il Kim, Ji Hee Jun, Hyunjung Baek, Jae-Hyo Kim, Beom-Joon Lee, Hee-Jae Jung
BACKGROUND: Radiation pneumonitis is a common and serious complication of radiotherapy. Many published randomized controlled studies (RCTs) reveal a growing trend of using herbal medicines as adjuvant therapy to prevent radiation pneumonitis; however, their efficacy and safety remain unexplored. OBJECTIVE: The aim of this systematic review is to evaluate the efficacy and safety of herbal medicines as adjunctive therapy for the prevention of radiation pneumonitis in patients with lung cancer who undergo radiotherapy...
2018: PloS One
https://www.readbyqxmd.com/read/29808081/treatment-of-sarcoma-lung-metastases-with-stereotactic-body-radiotherapy
#12
Adam D Lindsay, Edward E Haupt, Chung M Chan, Andre R Spiguel, Mark T Scarborough, Robert A Zlotecki, Parker C Gibbs
Background: The most common site of sarcoma metastasis is the lung. Surgical resection of pulmonary metastases and chemotherapy are treatment options that have been employed, but many patients are poor candidates for these treatments for multiple host or tumor-related reasons. In this group of patients, radiation might provide a less morbid treatment alternative. We sought to evaluate the efficacy of radiotherapy in the treatment of metastatic sarcoma to the lung. Methods: Stereotactic body radiotherapy (SBRT) was used to treat 117 pulmonary metastases in 44 patients...
2018: Sarcoma
https://www.readbyqxmd.com/read/29801721/can-dose-outside-the-ptv-influence-the-risk-of-distant-metastases-in-stage-i-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy-sbrt
#13
André Diamant, Avishek Chatterjee, Sergio Faria, Issam El Naqa, Houda Bahig, Edith Filion, Cliff Robinson, Hani Al-Halabi, Jan Seuntjens
BACKGROUND AND PURPOSE: In an era where little is known about the "abscopal" (out-of-the-field) effects of lung SBRT, we investigated correlations between the radiation dose proximally outside the PTV and the risk of cancer recurrence after SBRT in patients with primary stage I non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: This study included 217 stage I NSCLC patients across 2 institutions who received SBRT. Correlations between clinical and dosimetric factors were investigated...
May 22, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29799319/the-role-of-nrf2-in-the-response-to-normal-tissue-radiation-injury
#14
Brent D Cameron, Konjeti R Sekhar, Maxwell Ofori, Michael L Freeman
The transcription factor Nrf2 is an important modulator of antioxidant and drug metabolism, carbohydrate and lipid metabolism, as well as heme and iron metabolism. Regulation of Nrf2 expression occurs transcriptionally and post-transcriptionally. Post-transcriptional regulation entails ubiquitination followed by proteasome-dependent degradation. Additionally, Nrf2-mediated gene expression is subject to negative regulation by ATF3, Bach1 and cMyc. Nrf2-mediated gene expression is an important regulator of a cell's response to radiation...
May 25, 2018: Radiation Research
https://www.readbyqxmd.com/read/29794744/post-radiotherapy-maintenance-treatment-with-fluticasone-propionate-and-salmeterol-for-lung-cancer-patients-with-grade-iii-radiation-pneumonitis-a-case-report
#15
Pingping Zhang, Hongxia Yan, Sheng Wang, Jindan Kai, Guoliang Pi, Yi Peng, Xiyou Liu, Junwei Sun
RATIONALE: This combination of fluticasone propionate (FP) and the long-acting β2-agonist salmeterol (Salm) can control the symptoms of asthma and COPD better than FP or Salm on their own and better than the combination of inhaled corticosteroids plus montelukast. FP/Salm has been shown to control symptoms of asthma and COPD better than a double dose of inhaled steroids. The patient in our report had a history of COPD, and suffered relapse of RP when given only steroids. It is possible that COPD history helps explain this patient's more difficult treatment course...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29787423/autoimmune-granulomatous-inflammation-of-lacrimal-glands-and-axonal-neuritis-following-treatment-with-ipilimumab-and-radiation-therapy
#16
Ecaterina Ileana Dumbrava, Veronica Smith, Rasha Alfattal, Adel K El-Naggar, Marta Penas-Prado, Apostolia M Tsimberidou
Immune checkpoint inhibitors such as anti-CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), anti PD-1 (programmed cell death protein 1) and PD-L1 (programmed cell death protein-ligand 1) monoclonal antibodies are emerging as standard oncology treatments in various tumor types. The indications will expand as immunotherapies are being investigated in various tumors with promising results. Currently, there is inadequate identification of predictive biomarkers of response or toxicity. Unique response patterns include pseudoprogression and delayed response...
May 21, 2018: Journal of Immunotherapy
https://www.readbyqxmd.com/read/29764588/-correlations-between-ape1-ref-1-icam-1-and-il-17a-levels-in-serum-and-radiation-pneumonitis-for-local-advanced-non-small-cell-lung-cancer-patients
#17
Leiming Guo, Gaofeng Ding, Wencai Xu, Hong Ge, Yue Jiang, Yufei Lu
BACKGROUND: The main manifestations of radiation pneumonitis are injury of alveolar epithelial and endothelial cells, abnormal expression of cytokines, abnormal proliferation of fibroblasts and synthesis of fibrous matrix. The occurrence of radiation pneumonitis is associated with multiplecytokine level abnormality. These cytokines can also be used as bio-markers to predict the occurrence of radiation pneumonitis. This study was to evaluate the correlation between the change of apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ape1/Ref-1), intercellular adhesion molecules 1 (ICAM-1) and interleukin-17A (IL-17A) before and after radiotherapy and radiation pneumonitis for local advanced non-small cell lung cancer (NSCLC) patients with concurrent chemoradiotherapy...
May 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29756124/functional-promoter-rs189037-variant-of-atm-is-associated-with-decrease-in-lung-diffusing-capacity-after-irradiation-for-non-small-cell-lung-cancer
#18
Jose Luis Lopez Guerra, Yi-Peng Song, Quynh-Nhu Nguyen, Daniel R Gomez, Zhongxing Liao, Ting Xu
Objective: Single-nucleotide polymorphisms (SNPs) in the ataxia telangiectasia-mutated gene ATM have been linked with pneumonitis after radiotherapy for lung cancer but have not been evaluated in terms of pulmonary function impairment. Here we investigated potential associations between SNPs in ATM and changes in diffusing capacity of the lung for carbon monoxide (DLCO) in patients with non-small-cell lung cancer (NSCLC) after radiotherapy. Methods: From November 1998 through June 2009, 448 consecutive patients with inoperable primary NSCLC underwent definitive (≥60 Gy) radiotherapy, with or without chemotherapy...
March 2018: Chronic Diseases and Translational Medicine
https://www.readbyqxmd.com/read/29740320/amifostine-analog-drde-30-attenuates-bleomycin-induced-pulmonary-fibrosis-in-mice
#19
Aastha Arora, Vikas Bhuria, Puja P Hazari, Uma Pathak, Sweta Mathur, Bal G Roy, Rajat Sandhir, Ravi Soni, Bilikere S Dwarakanath, Anant N Bhatt
Bleomycin (BLM) is an effective curative option in the management of several malignancies including pleural effusions; but pulmonary toxicity, comprising of pneumonitis and fibrosis, poses challenge in its use as a front-line chemotherapeutic. Although Amifostine has been found to protect lungs from the toxic effects of radiation and BLM, its application is limited due to associated toxicity and unfavorable route of administration. Therefore, there is a need for selective, potent, and safe anti-fibrotic drugs...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29738279/cortical-thinning-and-structural-bone-changes-in-non-human-primates-after-single-fraction-whole-chest-irradiation
#20
Michael Farris, Emory R McTyre, Catherine Okoukoni, Greg Dugan, Brendan J Johnson, A William Blackstock, Michael T Munley, J Daniel Bourland, J Mark Cline, Jeffrey S Willey
Stereotactic body radiation therapy (SBRT) is associated with an increased risk of vertebral compression fracture. While bone is typically considered radiation resistant, fractures frequently occur within the first year of SBRT. The goal of this work was to determine if rapid deterioration of bone occurs in vertebrae after irradiation. Sixteen male rhesus macaque non-human primates (NHPs) were analyzed after whole-chest irradiation to a midplane dose of 10 Gy. Ages at the time of exposure varied from 45-134 months...
May 8, 2018: Radiation Research
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