Low Dose Irradiation-Induced Pneumonia: OAJBS Publishers

Low Dose Irradiation-Induced Pneumonia by Wen-Tian Lyu* in Open Access Journal of Biomedical Science (OAJBS)

Introduction: Low-dose irradiation with high dose rate-induced radiation pneumonia (RP) is rare, and the machanism is not clear. 

Patient concerns: A 65-year-old Chinese male patient, with a history of dust work, developed stage T4N2M0, IIIC lung cancer. He underwent four cycles of a paclitaxel plus cisplatin chemotherapeutic regimen. One month after chemotherapy, a chest CT scan revealed that the right main trachea was partially blocked, resulting in localized atelectasis. 

Diagnosis: Lung Cancer; Radiation Pneumonia 

Interventions: Palliative radiotherapy was conducted to relieve wheezing symptoms. Radiation doses were delivered as follows: A total of 6420 cGy in 30 fx was delivered to the blocked bronchus and another 5400 cGy in 30 fx to the gross tumor volume. The dose distribution in organs at risk revealed that the lung dose-volume for V20 and V30 were below the tolerance limit, and V5 exceeded this limit (V5 = 65%). Following radiation treatment, the wheezing symptoms were completely relieved and corroborated with a CT scan. One month after radiotherapy, the patient suffered a cold, and developed a fever and dyspnea. A CT scan showed signs of RP in the low-dose area, but no evidence in the high-irradiation-dose area. A blood test revealed that neutrophil, granulocyte and lymphocyte counts were normal. The patient was treated with oxygen inhalation, antibiotics and hormone therapy to release the dyspnea. 

Outcomes: Blood tests revealed that neutrophil, granulocyte and lymphocyte counts were normal. The body temperature was always higher than normal. The symptom of hypoxia was getting worse. The patient subsequently died of respiratory failure 20 days after developing cold symptoms. 

Conclusion: For the elder patients with poor pulmonary function and low immunity, low dose irradiation can lead to radiation pneumonia, which the cause was related to non-bacterial pathogenic microorganism infection.
https://biomedscis.com/fulltext/low-dose-irradiation-induced-pneumonia.ID.000276.php

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