Pacjenci, u których rozwinęło się popromienne zwłóknienie płuc, nie odnoszą korzyści z leczenia glikokortykosteroidami. Brakuje także innych skutecznych metod leczenia. W przypadku nasilonych objawów można rozważyć zastosowanie pentoksyfiliny (w dawce 400 mg 2-3 × na dobę) oraz witaminy E (w dawce 1000 j.m. na dobę). Wskazane jest podawanie gwajafenezyny w celu ułatwienia odkrztuszania zalegającej wydzieliny. Pomoc przynosi również odpowiednia rehabilitacja oddechowa.
ABSTRACT
Radiation-induced lung injury
Radiation-induced lung injury (RILI) is a general term for damage to the lung as a result of radiotherapy of the chest for lung cancer, breast cancer or lymphoid neoplasms. It occurs in 20% of patients and limits the maximum dose that can be delivered. There are two phases of radiation lung damage: radiation pneumonitis (RP), which is early inflammatory damage, and lung fibrosis (LF), a late pulmonary complication. Radiation pneumonitis develops 4 to 12 weeks after completion of the radiotherapy. Chronic pneumonitis can lead to pulmonary fibrosis, which develops 4-6 months after treatment. Radiation-induced lung tissue complication depends on several parameters. Both physical and biological factors determine lung tissue complication probability. The risk of radiation-induced lung toxicity cannot be completely avoided, but modern radiotherapy techniques partially prevent this. Most patients who develop radiation-induced pulmonary lesions are asymptomatic and do not require treatment. However, appropriate diagnosis of radiation pneumonitis and treatment, if necessary, are important because the quality of life is impaired.
KEYWORDS: radiation-induced lung injury, radiation pneumonitis, lung fibrosis.
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