Radiation Pneumonitis

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

Radiation pneumonitis is inflammation of the lungs caused by radiation therapy to the chest. This can affect patients who receive treatment for lung or breast cancer, lymphomas, thymic tumors, or esophageal cancer. It often starts about 1 to 12 months after treatment is done.

What are the symptoms of radiation pneumonitis?

  • Cough.
  • Low-grade fever.
  • Chest congestion.
  • Shortness of breath.
  • Chest pain.

What can increase my risk?

  • Receiving higher doses of radiation.
  • Smoking.
  • Having other lung diseases prior to treatment such as COPD and interstitial lung disease.
  • Being female.
  • Being over the age of 65.

How is radiation pneumonitis diagnosed?

Radiation pneumonitis can be hard to diagnose. Many lung diseases cause the same symptoms so it can be hard to tell which issue is causing them. There is no specific test to confirm radiation pneumonitis. Additional tests can help to make a diagnosis, these may include:

  • CT scan: Provides 3-D imaging that can better visualize the lungs.
  • Pulmonary function test: This helps look at lung function.
  • Chest X-ray: Shows changes to lungs that were exposed to radiation.

How is radiation pneumonitis treated?

Treatment of radiation pneumonitis depends on how severe it is. For some people, symptoms will go away on their own. If symptoms are more severe, steroids, such as prednisone, are often prescribed. Steroids decrease the inflammation in the lung.

Other treatments for radiation pneumonitis are:

  • Decongestants: Medications to decrease congestion.
  • Cough suppressants: Medications to decrease your cough.
  • Bronchodilators: Medications to help open your airways.
  • Oxygen therapy.

Many of these medications are available over-the-counter. You should check with your provider before taking any of these medications.

When should I contact my care team?

Radiation pneumonitis symptoms are similar to side effects from cancer, its treatment, or an infection such as pneumonia. You should contact your care team about any symptoms related to your breathing or overall health, especially if you have received radiation to your chest in the past 12 months. Your provider will be able to help determine what is causing the symptoms and what treatments may help.

References

Giuranno, L., Ient, J., De Ruysscher, D., & Vooijs, M. A. (2019). Radiation-Induced Lung Injury (RILI). Frontiers in oncology9, 877. https://doi.org/10.3389/fonc.2019.00877

Jain, V., & Berman, A. T. (2018). Radiation Pneumonitis: Old Problem, New Tricks. Cancers10(7), 222. https://doi.org/10.3390/cancers10070222

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