Radiation pneumonitis and fibrosis: mechanisms underlying its pathogenesis and implications for future research.
Radiation pneumonitis and subsequent radiation pulmonary fibrosis are the two main dose-limiting factors when irradiating the thorax that can have severe implications for patients' quality of life. In this article, the current concepts about the pathogenetic mechanisms underlying radiation pneumonitis and fibrosis are presented. The clinical course of fibrosis, a postulated acute inflammatory stage, and a late fibrotic and irreversible stage are discussed. The interplay of cells and the wide variety of molecules orchestrating the immunologic response to radiation, their interactions with specific receptors, and the cascade of events they trigger are elucidated. Finally, the implications of this knowledge with respect to the therapeutic interventions are critically presented.
Tsoutsou
Pelagia G
PG
Department of Radiation Oncology, Democritus University of Thrace, Alexandroupolis, Greece.
Koukourakis
Michael I
MI
D016207:Cytokines / Q000502:physiology; D006801:Humans; D015994:Incidence; D017564:Radiation Pneumonitis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy
D016207:Cytokines