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Review
. 2022 Jul 29;27(3):552-565.
doi: 10.5603/RPOR.a2022.0046. eCollection 2022.

Radiation-induced lung injury - what do we know in the era of modern radiotherapy?

Marek Konkol  1   2 , Paweł Śniatała  3 , Piotr Milecki  1   4
Affiliations
Review

Radiation-induced lung injury - what do we know in the era of modern radiotherapy?

Marek Konkol et al. Rep Pract Oncol Radiother. .

Abstract

Radiation-induced lung injury (RILI) that is usually divided into an early radiation-induced pneumonitis (RIP) and late chronic radiation-induced lung fibrosis (RILF) remains a clinically significant toxicity in radiation oncology. Thus, a thorough understanding of underlying molecular mechanisms and risk factors is crucial. This review, focused on patients treated with modern radiotherapy (RT) techniques, describes the different clinical presentations of RIP, with most typical imaging findings and usefulness of pulmonary function tests and laboratory assessment in differential diagnosis. The most critical patient- and treatment-related predictors are summarized and discussed - age and sex, comorbidities, tumour characteristics, concomitant treatment, and RT-plan parameters. The conventional grading scales and contemporary approach to quantitative assessment (radiomics, CT density changes) is described as well as treatment methods.

Keywords: CT-density changes; lung cancer radiotherapy; lung fibrosis; lung toxicity; radiation pneumonitis; radiation-induced lung injury.

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Conflict of interest statement

Conflict of interest None declared.

Figures

Figure 1
Figure 1
Imaging findings after thoracic radiotherapy (RT); CT — computed tomography; HU — Houndsfield units; PET — positron emission tomography; FDG — fluorodeoxyglucose; SUV — standardized uptake value. Elaborated on the basis of [–8]
See this image and copyright information in PMC

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