Diagnosis and treatment of radiation pneumonia / 中华放射肿瘤学杂志

ABSTRACT

Radiation pneumonia is a part of radiation-induced lung injury, and its injury and repair is a complex pathophysiological process involving with the participation and interaction among numerous cells and cytokines. Early diagnosis and treatment of radiation pneumonia can alleviate lung injury and protect lung fuction. Compared with infectious pneumonia, there is no obvious difference in symptoms and physical signs. However, the symptoms are relatively mild, the total count of white blood cells is not significantly elevated or only the classification of neutrophils is relatively high. Hormone can stimulate the increase of white blood cells, which should be delivered prior to relevant examination. CT scan is a sensitive tool to make the diagnosis of radiation pneumonia, which can be utilized for staging, guiding treatment and prognosis evaluation. The lung injury changes of radiation pneumonia on CT scan can be observed 7-10 d later than relevant symptoms. Besides symptomatic treatment, such as cough relief and phlegm elimination, hormone is the key treatment of radiation pneumonia. It is recommended to deliver long-acting dexamethasone or prednisone with an initial small dose, adjusted to effective dose according to disease condition, maintained for 3-4 weeks, and gradually reduced to avoid the recurrence of radiation pneumonia. Pulse therapy for hormone is likely to lead to insufficient or excessive dose and affect the therapeutic effect. Insufficient dose can cause the occurrence of recurrent radiation pneumonia.