Physiologic changes before and after radiation treatment for carcinoma of the lung

Germon, Patricia A.

doi:10.1001/jama.206.4.809

Cited by 23 publications

(1 citation statement)

References 12 publications

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“…The ability to compensate for such loss depends on pretreatment pulmonary function, the volume treated, and other patient factors. Improvements in pulmonary function resuiting from radiation response of lung tumors may compensate for losses due to radiation fibrosis [28][29][30]. Several authors have recently correlated radiation-related changes in lung density with computed tomographic (CT) findings [31,32].…”

Section: Pulmonary Effects Of Irradiationmentioning

confidence: 99%

Complications of radiation therapy and factors in their prevention

et al. 1986

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Radiation therapy of most malignant tumors requires dose‐fractionation regimens near the tolerance of the surrounding normal tissues. With the exception of the bone marrow and the lung in which the morbidity may be minimized by reducing the volume irradiated, other structures require limitations of total doses to minimize adverse effects. In thoracic irradiation, the most sensitive normal structure is the lung, while the heart and esophagus do not frequently have serious late effects. Pelvic irradiation carries a much greater risk of morbidity, primarily to the fixed segments of small bowel and less frequently to the large bowel and bladder. Irradiation of the upper aerodigestive tract may be complicated by necrosis of soft tissues and bone, especially the mandible. Dental management greatly affects the risk of complications. Bones and soft tissues elsewhere in the body are rarely affected except in the growing child. The normal pituitary may be irradiated when tumors near the base of the skull are treated. The production of growth hormone may especially be compromised in children. Acute, subacute, and late effects of irradiation of the brain are well recognized. While transient radiation myelopathy is frequent and not serious, progressive radiation myelopathy is rare but extremely grave. Host factors, other diseases, and technical aspects of radiation therapy affect the risks and severity of adverse effects on normal tissues. Surgical procedures may be important in preventing complications as well as in managing them.

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Section: Pulmonary Effects Of Irradiationmentioning

confidence: 99%

Complications of radiation therapy and factors in their prevention

et al. 1986

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Clinical radiation pneumonitis and radiographic changes after thoracic radiation therapy for lung carcinoma

Monson

Stark

Reilly

et al. 1998

Cancer

178

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Predictors of radiation response in lung cancer.A clinico-pathobiological analysis

Salazar

Rubin

Brown

et al. 1976

Cancer

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From February 1972 to July 1975, 200 lung cancer patients were seen at the University of Rochester Cancer Center's Division of Radiation Oncology; 40% had squamous cell tumors and 87.5% had advanced disease localized to the thorax. Of the 160 patients who completed treatment, 101 were treated with continuous therapy schedules, and 59 were treated with split-course schedules, and 59 were treated with split-course schedules; 40 patients did not complete treatment because of early metastatic disease or death. Radiation therapy was very effective in local tumor ablation. To assess local tumor response, doubling times were obtained in measurable lesions prior to treatment. The doubling times (DT) were 25 days for small cell cancers and 192 days for adenocarcinoma. More than 50% tumor shadow regression was a good prognosticator of local tumor response; this increased as the mean DT decreased. The order of kinetic increase in tumor ablation per histology was the opposite of the one-year survival results because of the metastatic spread patterns of the different tumors. Survival rates in lung cancer emerge as simplistic and inadequate to explain local radiation effectiveness. Survival is conditioned by stage, histology, and modality of treatment, total dose delivered, and local tumor response. Although the most effective treatment dose seems to be over 6000 rads, the most efficient schedules were split-course delivering lower tumor doses. This modality of treatment is proposed as the optimal schedule to be combined with other forms of therapy with the goal of achieving better survival.

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Physiologic changes before and after radiation treatment for carcinoma of the lung

Cited by 23 publications

References 12 publications

Complications of radiation therapy and factors in their prevention

Complications of radiation therapy and factors in their prevention

Clinical radiation pneumonitis and radiographic changes after thoracic radiation therapy for lung carcinoma

Predictors of radiation response in lung cancer.A clinico-pathobiological analysis

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