Radiation pneumonitis following large single dose irradiation: a re-evaluation based on absolute dose to lung

Journal Article · Wed Apr 01 04:00:00 EST 1981 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(81)90131-0· OSTI ID:6483171

Van Dyk, J; Keane, T J; Kan, S; Rider, W D; Fryer, C J.H.

The acute radiation pneumonitis syndrome is a major complication for patients receiving total thoracic irradiation in a large single dose. Previous studies have evaluated the onset of radiation pneumonitis on the basis of radiation doses calculated assuming unit density tissues. In this report, the incidence of radiation pneumonitis is determined as a function of absolute dose to lung. A simple algorithm relating dose correction factor to anterior-posterior patient diameter has been derived using a CT-aided treatment planning system. This algorithm was used to determine, retrospectively, the dose to lung for a group of 303 patients who had been treated with large field irradiation techniques. Of this group, 150 patients had no previous lung disease and had virtually no additional lung irradiation prior or subsequent to their large field treatment. The actuarial incidence of radiation pneumonitis versus dose to lung was evaluated using a simplified probit analysis. The resultant best fit sigmoidal complication curve demonstrates the onset of radiation pneumonitis to occur at about 750 rad with the 5% actuarial incidence occurring at approximately 820 rad. The errors associated with the dose determination procedure as well as the actuarial incidence calculations are considered. The time of onset of radiation pneumonitis occurs between 1 to 7 months after irradiation for 90% of the patients who developed pneumonitis with the peak incidence occurring at 2 at 3 months. No correlation was found between time of onset and the dose to lung over a dose range of 650 to 1250 rad.

• Research Organization: Princess Margaret Hospital, Toronto, Ontario
• OSTI ID: 6483171
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 7:4; ISSN IOBPD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALGORITHMS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DELAYED RADIATION EFFECTS
DOSES
EVALUATION
EXTERNAL IRRADIATION
IRRADIATION
LUNGS
MATHEMATICAL LOGIC
MEDICINE
NUCLEAR MEDICINE
ORGANS
PARTIAL BODY IRRADIATION
PATIENTS
PLANNING
PNEUMONITIS
RADIATION DOSES
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
THERAPY