RADIATION DAMAGE TO THORACIC TISSUES
Lesions in the chest developing after radiotherapy in 49 patients are described. Of all the thoracic tissues the lungs proved the most vulnerable to radiation damage. The risk is increased when large areas of lung are irradiated, the total dosage is high, and the course of treatment is given quickly. The 49 cases received irradiation of the thorax for breast cancer, malignant lymphomas, lung metastases, and esophageal and bronchial cancer. Seven of the 49 cases, all with severe bilateral damage, died from it. Thoracic irradiation caused in some cases constrictive pericarditis or was followed by transitory T wave changes in the electrocardiogram. The significance of the latter was uncertain. They were usually unassociated with cardiac symptoms or objective cardiac abnormality and disappeared within a year or less. Twelve of 27 patients studied showed such changes, and sudden death occurred in two. The most frequent manifestation of radiation damage to the bony structure of the thorax was fractured ribs. It usually followed postmastectomy radiotherapy. Other less common bony lesions attributable to radiation are described. Thoracic irradiation of females in childhood may result in mammary hypoplasia and absence of lactation. Radiation stricture of the esophagus was suspected in seven patients, but the diagnosis was disproved in each instance so this condition must be rare. The interval between the conclusion of x-ray treatment and development of symptoms attributable to radiation pneumonia varied from one to 16 weeks with a peak incidence at one month. Some people may be more sensitive to the harmful effects of radiation than others, but it was impossible to identify such subjects in advance of treatment. Age and arterial degenerative change did not appear to be relevant factors, but thin people seem more liable to radiation lung damage than those of greater body weight. Dominant influences in radiation lung damage were total dosage, rate of administration, and the percentage of the total lung volume irradiated; the risk was reduced if treatment was protracted in time. Six patients, undergoing wide-field thoracic irradiation, were given prophylactic cortisone in a dose of 75 to 100 mg daily during and for three months after radiotherapy. Of these, one died from radiation lung damage while still taking 50 mg cortisone daily and another developed a small area of radiation pneumonia which cleared completely while taking a similar dose. Phenindione was given to eight patients in whom wide-field thoracic irradiation was necessary, but of these three developed radiation pneumonia and one died from radiation damage to the heart, indicating that this anticoagulant may not diminish pulmonary radiation injury. (BBB)
- Research Organization:
- United Birmingham Hospitals, Birmingham, Eng.
- Sponsoring Organization:
- USDOE
- NSA Number:
- NSA-18-015888
- OSTI ID:
- 4068158
- Journal Information:
- Thorax (England), Vol. Vol: 18; Other Information: Orig. Receipt Date: 31-DEC-64
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
Similar Records
RADIATION PNEUMONIA
Dose-Dependent Pulmonary Toxicity After Postoperative Intensity-Modulated Radiotherapy for Malignant Pleural Mesothelioma
Related Subjects
AGE
BLOOD VESSELS
BONES
CANCER
COAGULATION
CORTISONE
DISEASES
DRUGS
ELECTRIC POTENTIAL
ELECTROCARDIOGRAPHY
GLANDS
HEART
HORMONES
KETONES
LUNGS
LYMPH SYSTEM
MAMMARY GLANDS
MAN
METASTASES
PHENETHYL RADICALS
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIOSENSITIVITY
RADIOTHERAPY
RECORDING SYSTEMS
SEX
X RADIATION