Department of Radiology, Izumi City General Hospital, Izumi, Japan.
Department of Medical Oncology, Izumi City General Hospital, Izumi, Japan.
Nagoya J Med Sci. 2022 Feb;84(1):180-184. doi: 10.18999/nagjms.84.1.180.
A 71-year-old man with stage IIB (Union for International Cancer Control, 8 edition) non-small cell lung cancer underwent intensity-modulated radiation therapy with a dose of 66 Gy administered in 33 fractions concomitant with carboplatin and paclitaxel therapy. On computed tomography after completion of radiation therapy, ground-glass opacity, which was larger on the contralateral side, was observed, but it was not observed in the high-dose area on the ipsilateral side. Although the adverse event theoretically shows dose dependency, it was finally diagnosed as radiation pneumonitis. The presence of an atypical distribution of radiation pneumonitis should be recognized to improve the diagnosis, and it is suggested that the relative volume of the normal contralateral lung receiving a dose of ≥5 Gy is a possible risk factor for radiation pneumonitis.
一位 71 岁的 IIB 期（国际抗癌联盟第 8 版）非小细胞肺癌患者接受了强度调制放疗，剂量为 66Gy，分 33 次给予，同时给予卡铂和紫杉醇治疗。在放疗完成后的计算机断层扫描中，观察到磨玻璃影，对侧较大，但同侧高剂量区未观察到。虽然不良事件理论上表现出剂量依赖性，但最终诊断为放射性肺炎。应认识到放射性肺炎的非典型分布，以提高诊断率，并且建议接受≥5Gy 剂量的正常对侧肺的相对体积是放射性肺炎的一个可能危险因素。
