Radioactive pneumonia

Overview of radioactive pneumonia (radiation pneumonitis), was due to lung cancer, breast cancer, esophageal cancer, malignant lymphoma, or other chest cancer after radiation therapy. the radiation field of the normal lung tissue damage caused by the inflammatory reaction. Light were asymptomatic, inflammation may dissipate; Severe lung undergoing extensive fibrosis, respiratory dysfunction, even cause respiratory failure. Radioactive cause pneumonia, and the severity of radiation, radioactivity, radiation area, speed were all closely related to radiation. Believe that the radioactivity threshold in three weeks for the 2500 ~ 3000rad. According to the Shanghai Medical University, Zhongshan Hospital statistics, the dose in less than six weeks of 2000 rad. generally very rare pneumonia, more than 4,000 rad dose of pneumonia was significantly increased, radioactivity over 6000 rad, there must be radiation pneumonitis. The greater the radiation field higher incidence; Radiation large area of lung tissue injury more serious radiation exposure faster. more susceptible to lung injury. Other factors such as the individual's tolerance to radiation poor, lung diseases such as pneumonia original, chronic bronchitis, Chronic obstructive pulmonary disease, and radiation therapy again so easy for radioactive pneumonia. Some chemotherapy drugs may also increase the lung response to radiation therapy. The elderly and children to radiation therapy poor tolerance. Pathological changes in the acute phase of the pathological changes occur after radiation therapy in a ~ February, some as late as six months after the end of treatment discovered. Performance of the pulmonary vascular injury, especially congestive capillaries, and cell edema Baptist weeping, alveolar type II cell regeneration low, Lymphangioma expansion and transparent membrane formation. Acute changes might have dissipated, but often cause pulmonary connective tissue hypertrophy, fibrosis and glass-like change. Chronic often occurred in radiation therapy after nine months, pathological extensive alveolar fibrosis, lung contraction, capillaries intimal thickening, hardening, luminal stenosis or obstruction which led to the increased pulmonary vascular resistance and pulmonary hypertension. Pleural also may inflammation and thickening and fibrosis. Bronchiole mucosa between change and secondary lung infection, can promote radiation fibrosis. Diagnosis based on the history of radiation therapy, dry coughing, sexual short breath and chest X-ray is inflammation or fibrosis diagnosis can be made, But with the deterioration of lung cancer and metastatic tumor differentiation phase, in order to avoid misdiagnosis intermittent radiotherapy; can be fatal. By bronchial epithelium after irradiation caused cells often change with the cancer cells to prudently distinction. Light clinical manifestations were asymptomatic, radiation therapy after more than two-three weeks onset of symptoms, often irritating, dry cough, with short breath and heart palpitations and chest pain, fever or low heat, occasional fever. Dyspnea with pulmonary fibrosis increase was aggravated sexual prone to respiratory infections and increased respiratory symptoms. Concurrent radiation esophagitis encountered difficulty swallowing. If radiation injury ribs, rib fractures have local tenderness is obvious. See medical radiation skin atrophy, stiffen, lung can hear and dry and wet friction Luo Tone Music. Pulmonary widespread and severe fibrosis, which leads to high pressure and pulmonary lung function of endogenous heart disease, corresponding signs. Radioactive treatment for the prevention of pneumonia, should strictly adhere to the total radiation dose and single-dose distribution, radiation field size. Radiation therapy for breast cancer, the best projection for Tangent minimize lung damage. In the course of radiation therapy, patients should be closely observed respiratory symptoms and whether the temperature rise. X-ray examination revealed pneumonia, should immediately stop radiotherapy. Treatment is symptomatic treatment, lung secondary infection with antibiotics. Early application of glucocorticoid effective. Generally use prednisone 40 mg / d, 4 hours, the service gradually reductions, 3 ~ 6 weeks for a course of treatment. Anticoagulant therapy for small blood clots invalid. Given oxygen inhalation can improve hypoxemia. Auxiliary lung function changes : radiation pneumonitis and pulmonary fibrosis are caused restrictive ventilatory dysfunction, reduced lung compliance, with ventilation / flow ratio is lowered and reduce the dispersion function, resulting in hypoxia. Sometimes we have found abnormal chest, and pulmonary function tests have shown changes. X-ray findings : The majority of radiotherapy stopped in January, the shadow lungs out. In the acute phase of the lung irradiation there Artemis temperature Flake fuzzy shadow, which can be seen video network, resembles bronchial pneumonia or pulmonary edema. The extent of the lesion and the surface of thoracic irradiation field line. Chronic lung fibrosis, was strip-shaped, massive shrinkage or limitations or atelectasis. Mediastinal pleura pericardium and a large number of adhesion, to the ipsilateral mediastinal shift, and increased ipsilateral diaphragmatic thoracic collapse.