Ionizing radiation (X-ray beam), breast, lung, esophageal cancers and is often used for the treatment of lymphoma. This treatment can cause lung and some injuries.
The beam of radiation dose applied to the lung tissue reaction brought husule, the duration varies depending on the status and treatment before the lung. Pnömonitis'i radiation or radiation from the reaction of the lung husule fibrosis'i called.
Many times the radiation treatment is done with 3000 rad, 6000 rad'dan pnömonitisine more radiation therapy can cause serious radiation.
Radiation dose and duration of light is important in the development of fibrosis'in. 3000 rad is given at a time, for example, consists of extensive fibrosis. 15 fractions are given the same dose (5 days a week 200 rad / day total of 3 weeks), radiation fibrosis'i rare. Beam at a dose of 3500 rad or more fibrosis, more frequently observed.
Usually 3-4 months after the initiation of X-ray therapy starts clinical and radiological manifestations. In some cases, this period is shorter, in some cases longer.
Before radiation therapy in patients with radiation pneumonitis in the lungs of chronic bronchitis is a more serious reaction. Because of the mediastinum underwent radiation adenopathy, mediastinal lymphatics and bilateral lung disease causes blockages in bringing husule.
Pathology
Before kapillerinde lung damage, destruction and necrosis occurs. Kolagen tissue capillaries takes place in the devastated. Within the alveolar exudate and hyaline-membrane occurs later. And the alveolar connective tissue and lymphatic infiltration septalarında develops. Then, a fibrous tissue invasion of lung parenkimasını is widespread and intense.
Clinical symptoms
There is a significant number of patients in clinical symptoms. Exertional dyspnea and the first clinical manifestation. In some cases, disappear every few weeks. Progressively increasing dyspnea at rest or in some cases, shows itself. Dry cough, in some cases, chest pain, weakness, subfebril fever, hemoptysis, tachycardia, and rarely comes husule. Early stage, patients may have temporary difficulties in swallowing. Radiation treatment of rib fractures in 10% of the cases come husule. Fracture is a serious chest pain that occurs in the region. This pain is increased more than inspiration.
Physical examination findings are usually minimal to slight. Initially, radiation can be heard in the area Railer age. This decrease Railer usually disappear. Because of intensive radiation therapy in advanced disease, fibrosis of the lung volume is reduced, pulled aside the trachea and mediastinal radiation, or dullness in that area has submatite decreased breath sounds and, in some cases, frotman heard.
Radiological findings
Pnömonotisinin the acute phase of radiation lung volume reduction parenkimasında concentration and monitored. This decrease in topo-segment or lobe of x-ray does not show compliance. Patchy or may be larger than the combined concentration of Parenchyma. The size and intensity of the radiation dose and lung lesions varies according to the reaction. Spatial loss comes from the widespread nature bronchiole blockage and reduction of surfactant material. Spatial reduction in almost every case, an air bronchogram was seen in the region.
Characteristic late appearance of radiation fibrosis. All the normal structure of fibrous tissue invaded the lung. Pleural thickening commonly seen.
Lung function tests
An improvement in lung function tests before income husule. This improvement is about the effect of radiation therapy in cancer tissue. The next period is reduced diffusing capacity and restrictive functional abnormality occurs, especially vital capacity and air flow is reduced. Generally, the fibrous tissue is proportional decrease in vital capacity and diffusion.
Treatment
Radiation fıbrosisini steroid treatment to prevent or pmömonitisini achieved a successful outcome in those very times. Acute oxygen therapy for hypoxemia in the growing and widely utilized in cases of fibrosis.
No comments:
Post a Comment