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Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints.

Publication ,  Journal Article
Marks, LB; Fan, M; Clough, R; Munley, M; Bentel, G; Coleman, RE; Jaszczak, R; Hollis, D; Anscher, M
Published in: Int J Radiat Biol
April 2000

PURPOSE: To assess the relationship between radiation (RT)-induced pulmonary symptoms and subclinical changes in pulmonary functions tests (PFT) and radiographs. MATERIALS AND METHODS: A total of 184 patients irradiated between 1992 and 1998 were prospectively evaluated for RT-induced pulmonary symptoms, changes in computed tomography (CT) density, reductions in single photon emission CT (SPECT) perfusion, and changes in pulmonary functions tests (forced expiratory volume in 1 s [FEV1] and diffusion capacity to carbon monoxide [DLCO]). Comparisons between the evaluable patients with (N=34) and without (N=106) RT-induced pulmonary symptoms were made. RESULTS: Within 6 months of RT, 80% of the RT-induced symptoms were noted. There was no association between the presence or absence of RT-induced pulmonary symptoms and the frequency of RT-induced radiographic changes (p=0.53), or in the dose-response curve for RT-induced reductions in regional perfusion. Overall, RT-induced changes in SPECT images were more commonly seen than increased density changes on CT (p<0.001). Most patients with pulmonary symptoms had relatively low pre-RT PFTs and experienced further declines following RT. CONCLUSIONS: Regional radiographic changes in CT-defined tissue density or SPECT-defined tissue perfusion are similar in patients with and without RT-induced pulmonary symptoms because these endpoints do not consider the volume of lung affected. RT-induced pulmonary symptoms are better related to post-RT PFT because they are an assessment of whole lung function. Additional studies are necessary to better define models that can predict the degree of radiation-induced changes in whole lung function.

Duke Scholars

Published In

Int J Radiat Biol

DOI

ISSN

0955-3002

Publication Date

April 2000

Volume

76

Issue

4

Start / End Page

469 / 475

Location

England

Related Subject Headings

  • Tomography, X-Ray Computed
  • Tomography, Emission-Computed, Single-Photon
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung
  • Humans
  • Female
  • Dose-Response Relationship, Radiation
 

Citation

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Marks, L. B., Fan, M., Clough, R., Munley, M., Bentel, G., Coleman, R. E., … Anscher, M. (2000). Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints. Int J Radiat Biol, 76(4), 469–475. https://doi.org/10.1080/095530000138466
Marks, L. B., M. Fan, R. Clough, M. Munley, G. Bentel, R. E. Coleman, R. Jaszczak, D. Hollis, and M. Anscher. “Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints.Int J Radiat Biol 76, no. 4 (April 2000): 469–75. https://doi.org/10.1080/095530000138466.
Marks LB, Fan M, Clough R, Munley M, Bentel G, Coleman RE, et al. Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints. Int J Radiat Biol. 2000 Apr;76(4):469–75.
Marks, L. B., et al. “Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints.Int J Radiat Biol, vol. 76, no. 4, Apr. 2000, pp. 469–75. Pubmed, doi:10.1080/095530000138466.
Marks LB, Fan M, Clough R, Munley M, Bentel G, Coleman RE, Jaszczak R, Hollis D, Anscher M. Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints. Int J Radiat Biol. 2000 Apr;76(4):469–475.
Journal cover image

Published In

Int J Radiat Biol

DOI

ISSN

0955-3002

Publication Date

April 2000

Volume

76

Issue

4

Start / End Page

469 / 475

Location

England

Related Subject Headings

  • Tomography, X-Ray Computed
  • Tomography, Emission-Computed, Single-Photon
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung
  • Humans
  • Female
  • Dose-Response Relationship, Radiation