Pulmonary Complications of Anticancer Treatment

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Chapter 58

Pulmonary Complications of Anticancer Treatment

Summary of Key Points

Radiation-Induced Lung Injury (Radiation Pneumonitis and/or Fibrosis)


• Prevention is far more important than treatment. Patients must be selected carefully for thoracic radiation, and irradiated volumes must be limited.

• Corticosteroids are very useful in the management of acute and subacute pneumonitis (although they have no prophylactic or therapeutic value in the management of long-term radiation fibrosis).

• A pulmonologist should be consulted for all grade 3 cases and most grade 2 cases.

• Oxygen should be administered as indicated to prevent hypoxia.

• High doses of corticosteroids (60 mg/day of prednisone) should be administered with slow tapering (over several weeks to months) for severe grade 2 or any grade 3 radiation pneumonitis.

• If prolonged corticosteroid treatment is anticipated, prophylaxis against corticosteroid complications is needed, including gastrointestinal, infectious, and osteoporosis prophylaxis and dietary and pharmacologic management of hyperglycemia.

• Antibiotics, bronchodilators, diuretics, and anticoagulation should be used as indicated for co-existing cardiopulmonary illnesses.

Drug-Induced Lung Injury

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