Radiation fibrosis

Mouse inhalation AM AD 1.4 pm o,2.0 luCeO (MO wks 378 life span radiation fibrosis of lung, squamous metaplasia of bronchi, thickening of arteries, radiation pneumonitis, squamous cell carcinoma 5/14 No No No (1972) Lundgren et ai. 

Metronidazole Bjorneklett et al., 1983 [23] NA 6 radiation fibrosis, small bowel diverticulosis 83%... 

The reversibility of radiation fibrosis in skin and subcutaneous tissues in response to antioxidants is supported by regression of indnration reported in a French non-randomized pilot study involving intramuscnlar administration of bovine liposomal Cu/Zn superoxide dismutase (SOD), 5 mg twice weekly for 3 weeks, to 34 patients with 42 distinct zones of superficial fibrosis. Softening of snbcutaneous induration was noted in 86% of fibrotic zones, with an actuarial response rate of 70% by 5 years. Complete regressions were noted in 7 of 42 (17%) of the fibrotic zones. Supportive data are reported with topical apphcations of SOD over a period of several months in 40 patients with fibrosis after postmastectomy radiotherapy for early breast cancer. These studies were not pursued after bovine spongiform encephalopathy (BSE) was recognized and bovine products withdrawn. 

Martin M, Lefaix J, Delanian S (2000) TGF-betal and radiation fibrosis a master switch and a specific therapeutic target Int J Radiat Oncol Biol Phys 47 277-290... 

Fig. 6.160a,b. Radiation fibrosis, a Short-axis and b long-axis 12-5 MHz US images of the brachial plexus nerves (white arrows) in the supraclavicular region obtained 1 year after radiation therapy for breast carcinoma in a patient with reversible brachial plexopathy. There is mild homogeneous swelling of the nerve fascicles (arrowheads) which appear less defined. No focal mass is observed. SA, subclavian artery... 

Radiation fibrosis typically occurs 6 months or more after radiation therapy. Fibrotic changes are variably present between 30 and 40 Gy, and are always seen after 40 Gy. Permanent scarring resulting in respiratory compromise may develop if the dose and volume of lung irradiated are excessive. The HRCT findings consist of a reticular pattern with associated traction bronchiectasis limited to the radiation portal (Worthy et al. 1997 Wah et al. 2003) (Fig. 6.2.20). 

Fig. 6.2.20a,b. Radiation fibrosis in a 48-year-old man after radiation therapy for lymphoma, a Chest radiograph obtained 1 year after radiation therapy shows bilateral fi-brotic changes in the paramediastinal lung zone (arrows). b CT scan confirms bilateral paramediastinal fibrosis in the field of irradiation (arrowheads). (With permission from Franquet et al. 2005a)... 

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