Radiation-induced lung injury

Mark V. Hendricks, W. Chris Sheils, W. Bruce Davis

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Radiation is an effective therapeutic option for malignant disease. Dosing techniques have been refined to the point that radiation therapy is usually safe and well tolerated. Unfortunately, damaging effects to normal lung inside the radiation field are unavoidable, leading to the clinical syndromes 'radiation pneumonitis' and 'radiation fibrosis.' Onset of disease occurs 6 weeks to 6 months after radiation and includes symptoms of dyspnea, cough, chest pain, and fever. Treatment of severe cases may require corticosteroids. A chest radiograph initially shows an alveolar infiltrate inside the radiation field that later develops the typical appearance of fibrotic changes that can mimic tumor or infection. The pathogenesis involves free radical formation that directly damages cells and DNA. In addition, a diffuse inflammatory response characterized by increased lymphocytes followed by a cascade of cytokines and growth factors directs the fibrotic process. This is also seen in the contralateral untreated lung. Increased understanding of these mechanisms will suggest new strategies for improving the efficacy of radiation therapy while limiting toxic side effects.

Original languageEnglish (US)
Pages (from-to)287-295
Number of pages9
JournalClinical Pulmonary Medicine
Issue number5
StatePublished - Sep 1999


  • Pulmonary fibrosis
  • Radiation
  • Radiation pneumonitis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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