Fatal pneumonitis associated with postoperative intensity-modulated radiotherapy in lung cancer: Case report and review

Hu,Yan; Li,Jingjing; Su,Xiaoyan

doi:10.3892/ol.2012.1053

Fatal pneumonitis associated with postoperative intensity-modulated radiotherapy in lung cancer: Case report and review

Authors:
- Yan Hu
- Jingjing Li
- Xiaoyan Su
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Affiliations: Department of Oncology, The First People's Hospital of Jingzhou, Jingzhou, Hubei 434000, P.R. China
Published online on: November 30, 2012 https://doi.org/10.3892/ol.2012.1053
Pages: 714-716

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Abstract

Radiation pneumonitis (RP) is the most significant complication of acute treatment-related toxicities in lung cancer. Intensity-modulated radiotherapy (IMRT) with inverse planning enables us to achieve the desired dose distribution. However, there are many high-risk procedures associated with lung irradiation, including chemotherapy and surgery. We report a case of fatal treatment-related pneumonitis, where the patient had undergone postoperative IMRT for lung cancer. Following completion of radiotherapy, the patient developed progressive dyspnea. A chest computed tomography (CT) scan revealed the presence of diffuse reticular interstitial processes and honeycombing in both lungs. The fibrotic change in both lungs in a transverse view was compatible with low-dose irradiation of non-target organs at risk. Acute radiation pneumonitis was diagnosed. For patients receiving postoperative IMRT, low-dose irradiation volumes should be considered for lungs, as well as strict dose-volume histogram (DVH) parameters.

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