PMID- 31467761
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2090-6846 (Print)
IS  - 2090-6854 (Electronic)
IS  - 2090-6854 (Linking)
VI  - 2019
DP  - 2019
TI  - Severe and Fatal Multilobar Nonclassic Radiation Pneumonitis following 
      Stereotactic Body Radiation Therapy (SBRT) for Treatment of Inoperable 
      Non-Small-Cell Lung Cancer: A Report of Two Cases and Possible Enhancement by 
      Concurrent Amiodarone.
PG  - 8754951
LID - 10.1155/2019/8754951 [doi]
LID - 8754951
AB  - Stereotactic body radiation therapy (SBRT) is considered the standard of care for 
      treatment of inoperable early stage non-small cell carcinoma of the lung. SBRT 
      delivers a very high dose of ionizing radiation to a relatively small region 
      encompassing the tumor and spares a significant portion of the remaining lung 
      from high doses. However, the conformal high dose comes at the expense of 
      treating a larger volume of normal lung to lower doses. In general, this has been 
      deemed to be acceptable with an overall lower risk of radiation pneumonitis. 
      However, in the face of predisposing factors, the higher doses delivered by this 
      technique may lead to an increase in radiation pneumonitis. We report on two 
      patients being treated with SBRT in which severe radiation pneumonitis developed 
      in spite of our radiation dosimetry being significantly below the acceptable 
      limit for lung toxicity. Both patients developed a "fulminant" form of radiation 
      pneumonitis with radiographic abnormalities well beyond the treated volume. In 
      one patient, the disease proved fatal. Both patients were on amiodarone at the 
      time SBRT was administered. Given the rarity of fulminant radiation pneumonitis, 
      especially with the relatively small fields treated by SBRT, we suspect that 
      amiodarone enhanced the pulmonary toxicity.
FAU - Georgiou, Anastasios
AU  - Georgiou A
AUID- ORCID: 0000-0002-3984-6498
AD  - Radiation Oncology, Carl Kirkland Cancer Center, 620 W. Forest Ave, Jackson, TN 
      38301, USA.
FAU - Farmer, Adam
AU  - Farmer A
AD  - Carl Kirkland Cancer Center, 620 W. Forest Ave., Jackson, TN 38301, USA.
LA  - eng
PT  - Case Reports
DEP - 20190804
PL  - United States
TA  - Case Rep Pulmonol
JT  - Case reports in pulmonology
JID - 101585355
PMC - PMC6699306
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2019/08/31 06:00
MHDA- 2019/08/31 06:01
PMCR- 2019/08/04
CRDT- 2019/08/31 06:00
PHST- 2019/04/13 00:00 [received]
PHST- 2019/06/29 00:00 [accepted]
PHST- 2019/08/31 06:00 [entrez]
PHST- 2019/08/31 06:00 [pubmed]
PHST- 2019/08/31 06:01 [medline]
PHST- 2019/08/04 00:00 [pmc-release]
AID - 10.1155/2019/8754951 [doi]
PST - epublish
SO  - Case Rep Pulmonol. 2019 Aug 4;2019:8754951. doi: 10.1155/2019/8754951. 
      eCollection 2019.