Radiation pneumonitis

Pulmonary Oxygen Toxicity Radiation Pneumonitis "Shock Lung"... 

Respiratory Effects. Inhalation exposure of dogs to 241 Am resulted in respiratory insufficiency and pneumonia as well as histopathologic changes in the lungs. Inhalation exposure of rats resulted in radiation pneumonitis. 

When relatively insoluble forms of l44Ce are inhaled, the primary effects are observed in the lungs and tracheobronchial lymph nodes. With large quantities of 144Ce, animals die of radiation pneumonitis and pulmonary fibrosis. The tracheobronchial lymph nodes are atrophic and fibrotic. At lower exposure levels pulmonary neoplasms are a prominent finding. 

Beagle dog inhalation "CeCl, AMAD t.5-2,4 ion a, 1.6-2.1 13-16 mos 70 life span (in progress) death, bone marrow aplasia and pancytopenia, radiation pneumonitis, pulmonary fibrosis, hepatic necrosis 11/48 Yes pulmonary adenoma, bronchtogenic adenocarcinoma 3/48 Yes he man- Yes giocarcinoma osteosarcoma, 6/48 leukemia 3/34 (primary) Benjamin et al. (1972b 1976c) Merickel et al. (1978)... 

Beagle dog inhalation l44Ce in fused aluminosilicate particles AMAD 1.6-2.2 pm o 1.3-1,6 3 mos 54 life span (in progress) pulmonary fibrosis, radiation pneumonitis, congenital heart failure 5/12 Yes hemangiosarcoma 4/12 Yes No hemangiosar- coma 1/12 Hanicka-Rebar (1978)... 

Beegle dog inhalation, 44Ce in fused aluminosilicate particles AMAD 1.6-2.3 pm o, 1.3—1.6 8-10.5 yr 54 life span (in progress) radiation pneumonitis, cong. heart failure, fibrosis 17/33 Yes bronchiolo alveolar carcinoma 3/33 No No Hahn et of. (1978b)... 

Beagle dog inhalation M4CeOi AMAD 0.3-3 pm adult 10 5 yr radiation pneumonitis, pulmonary fibrosis No No No Stuart et al. (1964) Stuart and Gaven (1967) Stuart and Gaven (1968)... 

Syrian hamster inhalation CeOa, 860°C AMAD 1-2 p 26 d 84 d 340 d 7 7 5 life span (in progress) radiation pneumonitis, pulmonary fibrosis No No No Hobbs et al. (1975)... 

Mouse repeated inhalation CeO, 850°C AMAD 1.2-1.5pm o, 1.4-1.7 8-10 wkfl 820 life span radiation pneumonitis Yes 14/92 pulmon aden. (7)k pulmon sarc. (1) pulmon care. (6) No No Lundgren et al. (1975)... 

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. 

Cohen IJ, Loven D, Schoenfeld T, Sandbank J, Kaplinsky C, Yaniv Y, Jaber L, Zaizov R. Dactinomycin potentiation of radiation pneumonitis a forgotten interaction. Pediatr Hematol Oncol 1991 8(2) 187-92. 

The combination of interferon alfa with 13-cw-retinoic acid may have potentiated the occurrence of fatal radiation pneumonitis (SEDA-21, 374). 

Patients receiving radiation therapy may experience complications including severe esophagitis, fatigue, radiation pneumonitis, and cardiac toxicity. These toxicities are usually more common and severe when radiation is combined with chemotherapy. The patient s baseline performance status and the degree of pulmonary dysfunction (e.g., chronic obstructive pulmonary disease from years of tobacco use) must be considered in the decision of radiation dosage and fractionation. 

Robnett TJ, Machtay M, Vines FF, et al. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys 2000 48 89-94. 

Scott BR. 1980. A model for early death caused by radiation pneumonitis and pulmonary fibrosis after inhaling insoluble radioactive particles. Bull Math Biol 42 447-459. 

Bone marrow totally depleted within days. Bone marrow transplant may or may not improve ultimate outcome, due to late radiation pneumonitis and fibrotic complications. Even minor wounds may prove ultimately fatal. 

Similar results were observed in animals given a single, acute inhalation exposure to plutonium- 238, as the more soluble dioxide or nitrate (Mewhinney et al. 1987a Park et al. 1988 Sanders 1977 Sanders et al. 1977). Studies in dogs (Park et al. 1988) and hamsters (Sanders 1977) have demonstrated that plutonium-239 was more toxic than plutonium-238. The primary cause of death in animals treated with plutonium-238 was also radiation pneumonitis. 

Death. No deaths in humans specifically associated with plutonium have been reported following acute plutonium exposure. Epidemiological studies of occupational cohorts did not report any increases in deaths due to nonmalignant diseases. However, the highest radiation levels reported in workers were 100- to 1,000-fold lower than the radiation levels that resulted in death (due to respiratory failure) in some laboratory animals. Acute exposures to high levels of plutonium isotopes, administered as dioxides, citrate, or nitrates, were fatal to several laboratory species when exposure occurred by the inhalation, oral, or injection routes. Survival time was radiation dose-related for all of these routes of exposure. By the inhalation route in animals, nonmalignant respiratory disease was characterized by radiation pneumonitis, pulmonary fibrosis, alveolar edema, and occasionally hyperplasia and metaplasia with death occurring within weeks or months of the initial exposure to... 

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