Radiationinduced lung injury in vivo 341 irradiation only. These occur at different times after completion of. However, in the absence of spd, the role of inos is limited to promoting inflammatory mediator signaling. Herein, we analyzed the role of inos and spd in radiationinduced lung injury. Radiationinduced lung injury rili was first described in 1898, soon after.
Cryptotanshinone ameliorates radiationinduced lung injury in. In the earlier time crude treatment technique, lack of image. The classic chest radiograph in radiationinduced lung. Development of a minipig model for lung injury induced by a. Unfortunately, the lung is a very radiosensitive organ and radiationinduced lung injury rili is a frequent consequence of thoracic rt, affecting about one in three patients. Acute and late phases are described, corresponding to radiation pneumonitis and radiation fibrosis, respectively. Pulmonary radiation injury most commonly occurs as a result of radiation therapy administered to treat cancer.
Radiation induced lung injury strategies for reducing damage while optimizing therapeutic dosage ericka wiebe, msc and george rodrigues md, frcpc, msc ericka wiebe, msc is a medical student at the schulich school of medicine, university of western ontario, london on. When lung tissue is irradiated by xray cells are injured by the direct or indirect action of radiation. Radiation pneumonitis occurs 6 to 12 weeks after thoracic irradiation, and is thought to be due to direct radiation induced lung injury. The role of radiation induced injury on lung cancer mdpi. Our data revealed that cts could efficiently preserve pulmonary function in rili rats and reduce early.
Erdosteine was administered orally via a gastric tube at a dose of 50 mgkg. Radiation therapy for treating lung cancer might lead to latephase pulmonary inflammation and fibrosis. Although rili can be clinically monitored using pulmonary function measurements, the regional functional effects of the injury are not well understood. Older patients 65 years old have less tolerance to rt and a major risk of developing adverse effects 41, 77. Pulmonary damage in hodgkins lymphoma patients treated. Mesenchymal stem cellbased therapy for radiationinduced. The discourse covers approaches such as therapeutic administration of natural products, current and prospective radioprotective drugs, and applications of mesenchymal stem cells for radiationinduced lung injury. Although rili can be clinically monitored using pulmonary function measurements, the regional functional effects of.
Radiationinduced lung injury rili encompasses any lung toxicity induced by radiation therapy rt and manifests acutely as radiation. Molecular mechanisms involved in the radiationinduced lung injury and approaches used to overcome this lung injury are discussed. In another study, it was found that the quantity of lung volume, taking a dose of 20 gy, was the most important factor in determining the incidence rate of radiationinduced lung injury 31, 32. Radiation induced damage to normal lung parenchyma remains the doselimiting factor in chest radiotherapy, involves other structures within the thorax in. We aimed to evaluate the radioprotective effect of arbutin on acute radiation. Recently, mice have been adopted to establish animal models of radiation. Potential treatment for radiationinduced lung injury. Thus, this study aimed to investigate the effects of silibinin in radiation induced lung injury with a mouse model. Radiationinduced lung injury rili encompasses any lung toxicity induced by radiation therapy rt and manifests acutely as radiation pneumonitis and chronically as radiation pulmonary fibrosis.
We found that radiation induced lung injury is associated with inosdependent acute lung injury, inflammation, and disruption of spd dodecamer structure. Radiation induced lung injury rili encompasses any lung toxicity induced by radiation therapy rt and manifests acutely as radiation pneumonitis and chronically as radiation pulmonary fibrosis. In general terms, such damage is divided into early inflammatory damage radiation pneumonitis and later complications of chronic scarring radiation fibrosis. Cryptotanshinone ameliorates radiationinduced lung injury. Normal lung parenchyma is often unavoidably exposed to radiation during thoracic radiotherapy for bronchogenic and systemic neoplasms. An estimated 15 percent of patients treated for lung cancer develop irreversible scarring of lung tissue, called radiation lung injury rli, a chronic, untreatable condition that can cause breathing difficulties and, in severe cases, death. Both types of lung injury are observed today in patients who have undergone thoracic irradiation for the treatment of lung, breast, or hematologic. Regardless of where or how an accident involving radiation happens, three types of radiation induced injury can occur. However, this condition is on the increase again, as the drug regains popularity as a urinary antiseptic. Fs is composed of high concentrations of omega3 fatty acids and lignans. Radiation induced lung injury in vivo 341 irradiation only. Radiationinduced lung injury and inflammation in mice.
Radiologic manifestations of radiationinduced lung disease rild, including groundglass opacities or consolidation in the acute phase and traction bronchiectasis, volume loss, and consolidation in the late phase, are well described in the literature,, fig 1, 1, 17. Mechanisms of radiation induced injury radiology key. Because most patients with thoracic and breast ma lignancies are expected to undergo rt in their. Rtog traditional scoring system for lung injury secondary to radiation. Benveniste mf, welsh j, godoy mc, betancourt sl, mawlawi or, munden rf. Fs, a nontoxic whole grain used as a nutritional supplement, has gained popularity because it is a rich source of natural antioxidants. Pulmonary damage in hodgkins lymphoma patients treated with. Dogs lived out their life span with complete pathology conducted at the time of death. Bleomycininduced lung injury may occur at a rate in the range of 320% 1. Establishment of a rat model of radiationinduced lung injury. Original article protective effects of erdosteine against. Radiation pneumonitis usually becomes clinically apparent from 2 to 6 months after completion of radiation therapy. Injury to the lung is common after therapeutic irradiation of intrathoracic and chest wall malignancies. Radiationinduced lung disease rild is a frequent complication of radiotherapy to the chest for chest wall or intrathoracic malignancies and can have a variety of appearances, especially depending on when the patient is imaged.
Radiationinduced lung injury rili is a general term for damage to the lungs as a result of exposure to ionizing radiation. Pulmonary toxicities and treatment of radiation therapy. Jul 16, 2019 molecular mechanisms involved in the radiation induced lung injury and approaches used to overcome this lung injury are discussed. Radiationinduced lung injury rili is the most common, doselimiting complication of thoracic radio and radiochemotherapy.
These two well known types of lung pathology indicate a direct physical insult of radiation on the lung. Radiation induces reactive oxygen and nitrogen species ros, ngs which leads to dna strand breaks and to epithelial cell death. Nonsmall cell lung carcinoma is one of the most fatal cancers and is often treated using thoracic radiotherapy rt. Radiation pneumonitis occurs 6 to 12 weeks after thoracic irradiation, and is thought to be due to direct radiationinduced lung injury. Because most patients with thoracic and breast malignancies are expected to undergo rt in their lifetime, many with curative intent, the population at risk is significant. When investigating the manifestations of rili and developing treatment strategies, ability to quantify the pathological progression of.
This study began the day before radiation treatment and continued for four days. Radiation induced lung injury rili is a general term for damage to the lungs as a result of exposure to ionizing radiation. Here, we investigated the effects and underlying mechanisms of cts on a rili rat model. To analyze radiationinduced lung injury ril after stereotactic body. Dietary flaxseed prevents radiationinduced oxidative lung.
Injury in the acute phase seems to be radiation dosedependent in that higher doses are associated with more severe pneumonitis. Schematic overview of the important steps leading to pulmonary toxicity after radiotherapy. This study investigated the clinical and dosimetric factors influencing rili in lungcancer patients receiving chemoradiotherapy for better radiation planning. Radiationinduced pneumonitis after unilateral irradiation of the rat lung leads to increased expression of nos and no production 176. Radiationinduced lung injury is characterized by an acute pneumonitic phase that is followed by a phase of chronic inflammation and fibrosis that develops months or years after irradiation 175. Therapeutic radiation doses for thoracic tumors are significantly restricted to decrease the risk of nontumor tissue damage, yet radiation. Radiationinduced damage to normal lung parenchyma remains a. Interstitial lung disease induced by drugs respiration 2004. Radiationinduced damage to normal lung parenchyma remains the doselimiting factor in chest radiotherapy, involves other structures within the thorax in. The role of alveolar epithelium in radiationinduced lung injury. Four patients who developed pneumonitis after unilateral thoracic irradiation for carcinoma of the breast were studied with bronchoalveolar lavage, gallium scan of the lung, and respiratory function tests.
Thus, this study aimed to investigate the effects of silibinin in radiationinduced lung injury with a mouse model. Dose escalation of thoracic radiation can improve the local tumor control and surivival, and is in the meantime limited by the occurrence of radiation induced lung injury rili. Cryptotanshinone cts was reported to repress a variety of systemic inflammation and alleviate cardiac fibrosis, but it is still unclear whether cts could prevent radiationinduced lung injury rili. The role of alveolar epithelium in radiationinduced lung. Inflammatory cells infiltrate the affected region to remove death cells. Superoxide dismutase inhibits radiationinduced lung injury in hamsters. Radiationinduced lung disease and the impact of radiation. George rodrigues md, frcpc, msc is a radiation oncol. Normal tissue complication possibility is used to predict the dosevolume relationship in low.
Frontiers radiationinduced lung injury rili oncology. Once the radiation dose exceeds the radiation threshold, radiation damage may extend beyond the intrinsic repair capacity of the human body, and radiationinduced lung injury occurs fig. Interstitial lung disease induced by drugs and radiation. Radiation induced damage to normal lung parenchyma remains the doselimiting factor in chest radiotherapy. Pdf superoxide dismutase inhibits radiationinduced lung. When investigating the manifestations of rili and developing treatment strategies, ability to quantify the pathological progression of lung fibrosis induced by radiation. Radiation pneumonitis rp and radiation fibrosis rf are two doselimiting toxicities of radiotherapy rt, especially for lung, and esophageal. Lung injury was identified as an important area of interest in radiation research after a significant number of victims died early from radiation induced lung injury rili after the chernobyl accident 1. The ameliorative effect of silibinin against radiation. Radiationinduced pulmonary fibrosis refers to a condition of inflammation and subsequent scarring of lung tissues caused by radiation. How cells recognize and respond to injury may influence the tissue response to radiation mcbride et al.
With increasing use of thoracic irradiation as well as the potential for pulmonary radiation exposure from nuclear and radiologic terrorism, normal lung parenchyma is at risk for radiation induced lung injury. Beagle dogs were exposed by inhalation to 90y, 91y, 144ce, or 90sr in fused clay particles. Prediction assessment and management asian pac j cancer prev, 16 7, 262617 introduction thoracic radiation can induce both acute and late effects on the lung. Development of a minipig model for lung injury induced by. The shape and distribution of radiationinduced lung disease vary with different radiation methods, and because radiationinduced lung changes are usually confined to the irradiated volume, 2, 4, interpretation of chest radiographs is often difficult without a precise knowledge of the radiation methods used. Radiationinduced lung injury an overview sciencedirect.
Radiationinduced lung injury is a common complication after esophageal, breast, etc. This manuscript evaluates the role of cell killing, tissue disorganization, and tissue damage on the induction of lung cancer following low dose rate radiation exposures from internally deposited radioactive materials. Radiationinduced lung injury strategies for reducing damage while optimizing therapeutic dosage ericka wiebe, msc and george rodrigues md, frcpc, msc ericka wiebe, msc is a medical student at the schulich school of medicine, university of western ontario, london on. Age is one of the main factors associated with radiationinduced lung toxicity.
Amiodarone pulmonary toxicity apt was recognized in 1980, and remains a significant. The role of alveolar epithelium in radiation induced lung injury. Radiationinduced lung injury patterns and the misdiagnosis after. Radiation induced lung injury rili was first described in 1898, soon after the development of roentgenograms. Radiationinduced lung injury rili encompasse s any lung toxicity induced by radiation therapy rt and manifests acutely as radiation pneumo nitis and chronically as radiation pulmonary. Radiation induced lung injury can occur in two phases viz. Radiationinduced lung disease radiology reference article. In the lung, as well as other late responding tissues, the relevance of the. Dec 22, 2016 although radiation is an important tool in the treatment of many cancer types, damage to some healthy lung tissue inevitably occurs. Radiation induced lung injury rili is an important doselimiting factor in radiation directed to the thorax and may primarily affect patients treated for lung cancer, breast cancer, lymphoma, or those who receive total body irradiation as part of a bone marrow transplant. Radiation induced lung injury is a common complication after esophageal, breast, etc. This condition is relatively common and follows radiation therapy administered to the chest region for certain cancers such as breast, lung, and neck cancers.
The type of injury sustained by the lung that is not exposed to radiation is different from either the acute radiation induced pneumonitis or the chronic radiation induced pulmonary fibrosis. Although radiation is an important tool in the treatment of many cancer types, damage to some healthy lung tissue inevitably occurs. Lung injury was identified as an important area of interest in radiation research after a significant number of victims died early from radiationinduced lung injury rili after the chernobyl accident 1. Radiationinduced lung injury rili was first described in 1898, soon after the development of roentgenograms.
Radiation induced lung injury asian pacific journal of cancer. Because the lung is extremely radiosensitive, radiationinduced lung injury occurs commonly. The shape and distribution of radiation induced lung disease vary with different radiation methods, and because radiation induced lung changes are usually confined to the irradiated volume, 2, 4, interpretation of chest radiographs is often difficult without a precise knowledge of the radiation methods used. The discourse covers approaches such as therapeutic administration of natural products, current and prospective radioprotective drugs, and applications of mesenchymal stem cells for radiation induced lung injury.
Cryptotanshinone cts was reported to repress a variety of systemic inflammation and alleviate cardiac fibrosis, but it is still unclear whether cts could prevent radiation induced lung injury rili. Detection of longitudinal lung structural and functional. In this study, we examined the ability of silibinin to mitigate lung injury in, and improve survival of. In lung cancer patients, the incidence of adverse effects after radiotherapy is related to clinical factors and a variety of dosimetric parameters. Radiationinduced lung injury rili is an important doselimiting factor in radiation directed to the thorax and may primarily affect patients treated for lung cancer, breast cancer, lymphoma, or those who receive total body irradiation as part of a bone marrow transplant. Since the lungs are very sensitive to ionizing radiation, radiationinduced lung diseases. Dec 16, 2018 radiation induced pulmonary fibrosis refers to a condition of inflammation and subsequent scarring of lung tissues caused by radiation this condition is relatively common and follows radiation therapy administered to the chest region for certain cancers such as breast, lung, and neck cancers. This experiment took new zealand white rabbits as experimental subjects, to establish chronic radiationinduced lung injury model with highdoes radiotherapy, an to study the imaging and. The cellular processes of radiationinduced injury begin within hours after irradiation, but the clinical and radiographic features may not be manifest for weeks to. Both types of lung injury are observed today in patients who have undergone thoracic irradiation for the treatment. The type of injury sustained by the lung that is not exposed to radiation is different from either the acute radiationinduced pneumonitis or the chronic radiationinduced pulmonary fibrosis. The remainder of this article is a general discussion of the effects of radiation on the lung. The demographics of patients affected by radiation induced lung disease are those of the underlying condition for which radiation therapy was performed.