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Radiation-induced organizing pneumonia after stereotactic body radiotherapy for lung tumor.

Ochiai S, Nomoto Y, Yamashita Y, Murashima S, Hasegawa D, Kurobe Y, Toyomasu Y, Kawamura T, Takada A, Ii N - J. Radiat. Res. (2015)

Bottom Line: A statistically significant association between G2/3 RP in the subacute phase and OP was shown ( P: = 0.040).In two of the five patients who developed OP, the symptoms and radiographic change were improved rapidly by corticosteroid administration.Three patients with minor symptoms were managed without corticosteroid administration and OP resolved without any relapse.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Matsusaka Central Hospital, 102 Kobou Kawai-machi, Matsusaka, Mie, 515-8566, Japan sochiai1981@gmail.com.

No MeSH data available.


Related in: MedlinePlus

Chest CT and dose distribution of stereotactic body radiotherapy (SBRT) of a 70-year-old male patient. Dose distribution of SBRT. Isodose lines of 60 Gy (blue), 50 Gy (green), 40 Gy (purple), 30 Gy (light blue), 20 Gy (lavender) and 0.5 Gy (yellow) (A, B). Radiation pneumonitis (RP) represents in high-dose irradiated area (C, orange arrow) and patchy opacity in left lung appeared 6 months after SBRT (D, red arrow). No significant change in RP 9 months after SBRT (E, orange arrow). The radiographic lesion in the left lung disappeared and a new lesion in the right lung appeared. (F, red arrow). These radiographic changes were considered to be the sequential change of organizing pneumonia (OP) (migration). RP resulted in fibrosis (G, orange arrow), and OP resolved without fibrosis at 12 months after SBRT (H).
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RRV049F2: Chest CT and dose distribution of stereotactic body radiotherapy (SBRT) of a 70-year-old male patient. Dose distribution of SBRT. Isodose lines of 60 Gy (blue), 50 Gy (green), 40 Gy (purple), 30 Gy (light blue), 20 Gy (lavender) and 0.5 Gy (yellow) (A, B). Radiation pneumonitis (RP) represents in high-dose irradiated area (C, orange arrow) and patchy opacity in left lung appeared 6 months after SBRT (D, red arrow). No significant change in RP 9 months after SBRT (E, orange arrow). The radiographic lesion in the left lung disappeared and a new lesion in the right lung appeared. (F, red arrow). These radiographic changes were considered to be the sequential change of organizing pneumonia (OP) (migration). RP resulted in fibrosis (G, orange arrow), and OP resolved without fibrosis at 12 months after SBRT (H).

Mentions: The clinical course and characteristics of OP are summarized in Table 3. An example of OP is shown in Fig. 2. Four males and one female developed OP, and the age ranged from 70 to 85 years old. The irradiated dose was 48 Gy in four fractions in three patients and 60 Gy in eight fractions in another two patients. G2/3 RP was observed in two patients before the development of OP. Two patients had major (Grade 2) symptoms. They were administered with corticosteroid as an initial treatment for OP, and symptoms and radiographic change improved rapidly. Relapse of OP was observed in one patient after suspending corticosteroid administration, and re-administration of corticosteroid was required. Corticosteroids to the two patients were being tapered at the time of the analysis. The other three patients with minor symptoms (Grade 1) were managed without corticosteroid treatment and the symptoms and the radiographic change were resolved within 3–6 months after diagnosis. No relapse was observed in these patients during the follow-up.Table 3.


Radiation-induced organizing pneumonia after stereotactic body radiotherapy for lung tumor.

Ochiai S, Nomoto Y, Yamashita Y, Murashima S, Hasegawa D, Kurobe Y, Toyomasu Y, Kawamura T, Takada A, Ii N - J. Radiat. Res. (2015)

Chest CT and dose distribution of stereotactic body radiotherapy (SBRT) of a 70-year-old male patient. Dose distribution of SBRT. Isodose lines of 60 Gy (blue), 50 Gy (green), 40 Gy (purple), 30 Gy (light blue), 20 Gy (lavender) and 0.5 Gy (yellow) (A, B). Radiation pneumonitis (RP) represents in high-dose irradiated area (C, orange arrow) and patchy opacity in left lung appeared 6 months after SBRT (D, red arrow). No significant change in RP 9 months after SBRT (E, orange arrow). The radiographic lesion in the left lung disappeared and a new lesion in the right lung appeared. (F, red arrow). These radiographic changes were considered to be the sequential change of organizing pneumonia (OP) (migration). RP resulted in fibrosis (G, orange arrow), and OP resolved without fibrosis at 12 months after SBRT (H).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4628220&req=5

RRV049F2: Chest CT and dose distribution of stereotactic body radiotherapy (SBRT) of a 70-year-old male patient. Dose distribution of SBRT. Isodose lines of 60 Gy (blue), 50 Gy (green), 40 Gy (purple), 30 Gy (light blue), 20 Gy (lavender) and 0.5 Gy (yellow) (A, B). Radiation pneumonitis (RP) represents in high-dose irradiated area (C, orange arrow) and patchy opacity in left lung appeared 6 months after SBRT (D, red arrow). No significant change in RP 9 months after SBRT (E, orange arrow). The radiographic lesion in the left lung disappeared and a new lesion in the right lung appeared. (F, red arrow). These radiographic changes were considered to be the sequential change of organizing pneumonia (OP) (migration). RP resulted in fibrosis (G, orange arrow), and OP resolved without fibrosis at 12 months after SBRT (H).
Mentions: The clinical course and characteristics of OP are summarized in Table 3. An example of OP is shown in Fig. 2. Four males and one female developed OP, and the age ranged from 70 to 85 years old. The irradiated dose was 48 Gy in four fractions in three patients and 60 Gy in eight fractions in another two patients. G2/3 RP was observed in two patients before the development of OP. Two patients had major (Grade 2) symptoms. They were administered with corticosteroid as an initial treatment for OP, and symptoms and radiographic change improved rapidly. Relapse of OP was observed in one patient after suspending corticosteroid administration, and re-administration of corticosteroid was required. Corticosteroids to the two patients were being tapered at the time of the analysis. The other three patients with minor symptoms (Grade 1) were managed without corticosteroid treatment and the symptoms and the radiographic change were resolved within 3–6 months after diagnosis. No relapse was observed in these patients during the follow-up.Table 3.

Bottom Line: A statistically significant association between G2/3 RP in the subacute phase and OP was shown ( P: = 0.040).In two of the five patients who developed OP, the symptoms and radiographic change were improved rapidly by corticosteroid administration.Three patients with minor symptoms were managed without corticosteroid administration and OP resolved without any relapse.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Matsusaka Central Hospital, 102 Kobou Kawai-machi, Matsusaka, Mie, 515-8566, Japan sochiai1981@gmail.com.

No MeSH data available.


Related in: MedlinePlus