Radiation-induced lung toxicity - cellular and molecular mechanisms of pathogenesis, management, and literature review.

Lukas Käsmann, Alexander Dietrich, Claudia A Staab-Weijnitz, Farkhad Manapov, Jürgen Behr, Andreas Rimner, Branislav Jeremic, Suresh Senan, Dirk De Ruysscher, Kirsten Lauber, Claus Belka

Journal: Radiation oncology (London, England) 2021;15(1):214

PMID: 32912295

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Abstract

Lung, breast, and esophageal cancer represent three common malignancies with high incidence and mortality worldwide. The management of these tumors critically relies on radiotherapy as a major part of multi-modality care, and treatment-related toxicities, such as radiation-induced pneumonitis and/or lung fibrosis, are important dose limiting factors with direct impact on patient outcomes and quality of life. In this review, we summarize the current understanding of radiation-induced pneumonitis and pulmonary fibrosis, present predictive factors as well as recent diagnostic and therapeutic advances. Novel candidates for molecularly targeted approaches to prevent and/or treat radiation-induced pneumonitis and pulmonary fibrosis are discussed.

Address: Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. [email protected].; German Center for Lung Research (DZL), partner site Munich, Munich, Germany. [email protected].; German Cancer Consortium (DKTK), partner site Munich, Munich, Germany. [email protected].; Walther Straub Institute of Pharmacology and Toxicology, Member of the German Center for Lung Research (DZL), Medical Faculty, LMU-Munich, Munich, Germany.; German Center for Lung Research (DZL), partner site Munich, Munich, Germany.; Institute of Lung Biology and Disease, Helmholtz Zentrum München, Munich, Germany.; Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.; German Cancer Consortium (DKTK), partner site Munich, Munich, Germany.; Department of Internal Medicine V, LMU Munich, Munich, Germany.; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.; Research Institute of Clinical Medicine, Tbilisi, Georgia.; Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, Netherlands.; Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.

DOI: 10.1186/s13014-020-01654-9

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MeSH Terms: Humans, Pulmonary Fibrosis, Radiation Injuries, Radiation Pneumonitis, Radiotherapy Dosage