title: Case report of two patients having successful surgery for lung cancer after treatment for Grade 2 radiation pneumonitis.
abstract: BACKGROUND
  Surgery for locally advanced lung cancer is carried out following chemoradiotherapy. However, there are no reports clarifying what the effects on the subsequent prognosis are when surgery is carried out in cases with radiation pneumonitis. In this paper, we report on 2 cases of non-small cell lung cancer with Grade 2 radiation pneumonitis after induction chemoradiotherapy, in which we were able to safely perform radical surgery subsequent to the treatment for pneumonia.
  
  
  METHODS
  Case 1 was a 68-year-old male with a diagnosis of squamous cell lung cancer cT2aN2M0, Stage IIIA. Sixty days after completion of the radiotherapy, Grade 2 radiation pneumonitis was diagnosed. After administration of predonine, and upon checking that the radiation pneumonitis had improved, radical surgery was performed. Case 2 was a 63-year-old male. He was diagnosed with squamous cell lung cancer cT2bN1M0, Stage IIB. One hundred and twenty days after completion of the radiotherapy, he was diagnosed with Grade 2 radiation pneumonitis. After administration of predonine, the symptoms disappeared, and radical surgery was performed. In both cases, the postoperative course was favorable, without complications, and the patients were discharged.
  
  
  CONCLUSIONS
  Surgery for lung cancer on patients with Grade 2 radiation pneumonitis should be deferred until the patients complete steroid therapy, and the clinical pneumonitis is cured. Moreover, it is believed that it is important to remove the resolved radiation pneumonitis without leaving any residual areas and not to cut into any areas of active radiation pneumonitis as much as possible.
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakajima
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Atari
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Mitsuro
authors.initials: M
authors.lastname: Fukuhara
authors.affiliation: Department of Radiation Oncology, Saitama Cancer Center, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Division of Thoracic Oncology, Saitama Cancer Center, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Division of Thoracic Surgery, Saitama Cancer Center, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
keywords: Induction chemoradiotherapy; Locally advanced non-small cell lung cancer; Radiation pneumonitis; Surgical indication