Radiation Pneumonitis

Author: Courtney Misher, MPH, BS R.T.(T)
Last Reviewed: junho 29, 2023

Radiation pneumonitis is inflammation of the lungs caused by radiation therapy to the chest. It can happen after treatment for lung or breast cancer, lymphomas, thymic tumors, or esophageal cancer. It often starts about 1 to 3 months after treatment but can happen up to 12 months after treatment.

What are the symptoms of radiation pneumonitis?

The most common symptoms of radiation pneumonitis are:

What are the risk factors?

After receiving radiation therapy, the biggest risk factor is the size of the treatment area. The larger the treatment area, the higher the risk of getting radiation pneumonitis. Due to advances in radiation treatment delivery, the risk can be lessened.

Other factors that can increase your risk are:

  • Receiving chemotherapy at the same time as radiation therapy.
  • Receiving higher doses of radiation.
  • Having other lung diseases before treatment, such as COPD.
  • Being over the age of 65.
  • Where the tumor is found.

How is radiation pneumonitis diagnosed?

There is no specific test to diagnose radiation pneumonitis. Radiation pneumonitis has many of the same symptoms as other lung conditions, making it hard to tell which issue is causing them. Because of this, it can be hard to diagnose. Your care team will make the diagnosis from the symptoms you are having and from ruling out other causes. Tests that can help make this diagnosis or rule out other causes may include:

  • Chest CT scan: Provides a 3-D picture that shows a clearer image of your lungs.
  • Pulmonary function test: Looks at how well your lungs are working.
  • Chest X-ray: Shows changes to your lungs that were exposed to radiation.

How is radiation pneumonitis treated?

Treatment of radiation pneumonitis depends on how severe it is. If your symptoms are mild, they may go away on their own. However, if your symptoms are severe, steroids, such as prednisone, are often prescribed. Steroids help by lessening the inflammation in your lungs.

Other treatments for radiation pneumonitis are:

  • Decongestants: Medications to lessen congestion.
  • Cough suppressants: Medications to lessen your cough.
  • Bronchodilators: Medications to help open your airways.
  • Oxygen therapy: Getting additional oxygen to improve your breathing.

Many of these medications are available over the counter. Check with your care team before taking any of these medications.

When should I contact my care team?

Contact your care team about any symptoms related to your breathing or overall health, especially if you’ve had radiation to your chest in the past 12 months.

Giuranno, L., Ient, J., De Ruysscher, D., & Vooijs, M. A. (2019). Radiation-Induced Lung Injury (RILI). Frontiers in oncology, 9, 877. https://doi.org/10.3389/fonc.2019.00877

Jain, V., & Berman, A. T. (2018). Radiation Pneumonitis: Old Problem, New Tricks. Cancers, 10(7), 222. https://doi.org/10.3390/cancers10070222

Ullah, T., Patel, H., Pena, G. M., Shah, R., & Fein, A. M. (2020). A contemporary review of radiation pneumonitis. Current opinion in pulmonary medicine, 26(4), 321–325. https://doi.org/10.1097/MCP.0000000000000682

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