TY - JOUR
AU - Phillips, Theodore L.
AB - Whole-Lung Irradiation for Metastatic Tumor 1 Lawrence W. Margolis , M.D. and Theodore L. Phillips , M.D. Department of Radiology University of California San Francisco Medical Center San Francisco, Calif. 94122 Excerpt In The Treatment of metastatic disease of the lung, the injury to the lung parenchyma from irradiation must be weighed against the possibility of long-term control. A clinical picture of radiation injury to the lung was first described by Groover et al . in 1922 (7). Symptoms usually begin one to three months after a protracted course of radiation therapy, but may be delayed as long as six months (16). The acute reaction may subside leaving no clinical or roentogenographic residua, or it may progress to an irreversible fibrosis (2, 17, 18, 20). Variables known to influence the development of radiation pneumonitis include the dose of radiation, the plan of fractionation, the volume of lung treated, infection, and modifying drugs (5,8, 11, 13, 16). In this study these factors are correlated with the development of radiation pneumonitis and with control of the tumor after whole-lung irradiation for metastatic tumors. Material And Method This series consists of 25 patients treated at the University of California San Francisco Medical Center between 1958 and 1968 for metastatic tumor in the lungs. The ages of the patients ranged from two and one-half years to fifty-five years. Wilms's tumor was present in 10 patients, Ewing's sarcoma in 7, and miscellaneous primary malignant tumors in 8. To meet the criteria for inclusion in the study, radiation had to be delivered to a volume equal to at least one whole lung. The treatment was given with a 1 MeV x-ray unit or a cobalt-60 apparatus. In 6 patients with Wilms's tumor, actino-mycin D had been administered in conjunction with radiation therapy. Usually, it had been given in courses of 75 µg per kg in five equal doses. The courses were repeated several times either at monthly or three-month intervals. Radiation doses of 550 to 5,500 rads were delivered in periods of from fifteen to one hundred and seven days. The recorded doses had been calculated as midplane tissue doses in rads without correction for inhomogeneity and decreased density in the lungs. Because of the difficulty of accurate corrections, the data here are expressed simply as midline doses in rads, without this correction. The delivered doses were also converted to nominal single doses (NSD) 2 to facilitate comparison of the widely varying schedules. The calculation of NSD has been explained in detail by Ellis (4). All patients in this study in whom radiation pneumonitis developed presented clinical symptoms of cough, fever, or dyspnea. Definite roentgenographic changes were also noted, which consisted of shrinkage or displacement of a portion of the lung, a striated infiltrative pattern, or diffuse opacities. Material was obtained from the irradiated lung of 2 patients at necropsy and of another at surgery. Thin sections of this tissue were examined by standard histologic means.
TI - Whole-Lung Irradiation for Metastatic Tumor
JF - Radiology
DO - 10.1148/93.5.1173
DA - 1969-11-01
UR - https://www.deepdyve.com/lp/radiological-society-of-north-america-inc/whole-lung-irradiation-for-metastatic-tumor-RnKvUbZfp1
SP - 1173
VL - 93
IS - 5
DP - DeepDyve
ER -