A model for early death caused by radiation pneumonitis and pulmonary fibrosis after inhaling insoluble radioactive particles

1980 ◽  
Vol 42 (3) ◽  
pp. 447-459 ◽  
Author(s):  
B. R. Scott
Keyword(s):  
Pulmonary Fibrosis ◽  
Radiation Pneumonitis ◽  
Early Death

scholarly journals Treatment of chronic fibrosing interstitial lung diseases

2021 ◽  
Vol 64 (4) ◽  
pp. 277-285
Author(s):  
Jongmin Lee
Keyword(s):  
Pulmonary Fibrosis ◽  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Early Death ◽  
Interstitial Lung Diseases ◽  
Appropriate Treatment ◽  
Heterogenous Group ◽  
Nonspecific Interstitial Pneumonia ◽  
Prediction Of Prognosis

Interstitial lung diseases (ILD) refers to a large and heterogenous group of parenchymal lung disorders. It is difficult to diagnose and classify ILD. Nevertheless, accurate diagnosis of ILD is crucial for appropriate treatment selection and prediction of prognosis. Idiopathic pulmonary fibrosis (IPF), the most severe of the chronic forms of ILD, is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. In addition to IPF, a subset of patients with ILD may develop progressive fibrotic changes in lungs. As pulmonary fibrosis progresses, lung function gradually deteriorates and respiratory symptoms worsen; besides, quality of life is also impaired. Progressive fibrosis is also associated with limited response to immunomodulatory thrapies and, potentially, early death. A progressive fibrosing phenotype of ILD (PF-ILD), a subtype of ILD, shows morphological similarities, common underlying pathophysiologic mechanisms, and consistently progressive worsening. PF-ILD include idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, autoimmune ILD, chronic sarcoidosis, chronic hypersensitivity pneumonitis and environmental lung diseases. Antifibrotic agents pirfenidone and nintedanib have showed positive results not only for IPF but also for PF-ILD. Immunosuppressive therapy can be used for some types of PF-ILD. If a patient with PF-ILD does not respond to conventional treatment, lung transplantation may be a treatment option. Clinical trials on the treatment of PF-ILD are actively underway. Therefore, over the course of the next several years, major advances in PF-ILD treatment can be expected.

scholarly journals Toll-like Receptor 5 Agonism Protects Mice from Radiation Pneumonitis and Pulmonary Fibrosis

2012 ◽  
Vol 13 (9) ◽  
pp. 4763-4767 ◽  
Author(s):  
Zhi-Dong Wang ◽  
Yu-Lei Qiao ◽  
Xi-Feng Tian ◽  
Xue-Qing Zhang ◽  
Shi-Xiang Zhou ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Radiation Pneumonitis ◽  
Toll Like Receptor ◽  
Toll Like Receptor 5

scholarly journals The therapy of idiopathic pulmonary fibrosis: what is next?

2019 ◽  
Vol 28 (153) ◽  
pp. 190021 ◽  
Author(s):  
Vivien Somogyi ◽  
Nazia Chaudhuri ◽  
Sebastiano Emanuele Torrisi ◽  
Nicolas Kahn ◽  
Veronika Müller ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Symptom Control ◽  
Early Death ◽  
Clinical Diagnostics ◽  
Lung Function Decline ◽  
Clinical Phase ◽  
New Therapeutic Approaches ◽  
Improve Symptom ◽  
Acute Exacerbations

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease, characterised by progressive scarring of the lung and associated with a high burden of disease and early death. The pathophysiological understanding, clinical diagnostics and therapy of IPF have significantly evolved in recent years. While the recent introduction of the two antifibrotic drugs pirfenidone and nintedanib led to a significant reduction in lung function decline, there is still no cure for IPF; thus, new therapeutic approaches are needed. Currently, several clinical phase I–III trials are focusing on novel therapeutic targets. Furthermore, new approaches in nonpharmacological treatments in palliative care, pulmonary rehabilitation, lung transplantation, management of comorbidities and acute exacerbations aim to improve symptom control and quality of life. Here we summarise new therapeutic attempts and potential future approaches to treat this devastating disease.

PO-0681: Improved prediction of severe radiation pneumonitis by combining V20, VS5, pulmonary fibrosis on CT, and age

2014 ◽  
Vol 111 ◽  
pp. S13
Author(s):  
K. Tsujino ◽  
T. Hashimoto ◽  
T. Shimada ◽  
Y. Ota ◽  
O. Muraoka ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Radiation Pneumonitis

scholarly journals Predicting factors of symptomatic radiation pneumonitis induced by durvalumab following concurrent chemoradiotherapy in locally advanced non-small cell lung cancer

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Hiroshi Mayahara ◽  
Kazuyuki Uehara ◽  
Aya Harada ◽  
Keiji Kitatani ◽  
Tomonori Yabuuchi ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Predictive Factors ◽  
Concurrent Chemoradiotherapy ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Standard Of Care ◽  
Small Cell ◽  
High Dose ◽  
Predicting Factors ◽  
Dose Volumes

Abstract Background Concurrent chemoradiotherapy (CCRT) followed by durvalumab is the standard of care for unresectable locally-advanced non-small cell carcinoma (LA-NSCLC). However, a major concern about administration of durvalumab after CCRT is whether the incidence of symptomatic radiation pneumonitis (RP) may increase or not. In the present analysis, we report the initial results of CCRT followed by durvalumab in patients with LA-NSCLC in a real-world setting with focus on predicting factors for symptomatic RP. Methods Patients who were pathologically diagnosed as NSCLC and initiated treatment with CCRT followed by durvalumab between July 2018 to December 2019 were eligible for this study. Patients were included if they completed the planned CRT course and administered at least one course of durvalumab. We retrospectively investigated the preliminary survival outcome and incidence and predicting factors for symptomatic RP. Results Of the 67 patients who planned CCRT, 63 patients completed the entire CCRT course. Of these, 56 patients proceeded to consolidation with durvalumab. The median time to eternal discontinuation of durvalumab was 9.7 months. The cumulative proportion of the patients who exhibited symptomatic RP was 30, 40 and 44% at 3, 6 and 12 months, respectively. In multivariate analyses, pulmonary fibrosis score and lung V40 were significant predictive factors for symptomatic RP (p < 0.001, HR: 7.83, 95% CI: 3.38–18.13, and p = 0.034, HR: 3.17, 95% CI: 1.09–9.19, respectively). Conclusions Pulmonary fibrosis sore and lung V40 were significant predictive factors for symptomatic RP. We should be cautious about the administration of durvalumab for patients having subclinical pulmonary fibrosis. To our best knowledge, this is one of the first report showing the predictive value of high dose volumes to the lung in patients with LA-NSCLC who received CCRT followed by durvalumab.

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