How do you manage early and symptomatic fibrosis in lung cancer patients after RT?

I’ve noticed some patients develop worsening SOB and DOE months after RT and rather than interstitial diffuse pattern you would see with pneumonitis, I see a more fibrotic pattern. Would you recommend steroids? Or pentoxifylline and vitamin E?

Answer from: Radiation Oncologist at Academic Institution

Fibrotic changes following lung radiotherapy are common, and I think the challenge here is determining whether the pulmonary symptoms are due to radiotherapy (pneumonitis) or exacerbation of underlying pathology.Initiating a patient on steroids is typically a several week commitment, with subse...

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Radiation Oncologist at University of Texas MD Anderson Cancer Center
Very good summary.

Answer from: Radiation Oncologist at Academic Institution

With the widespread use of immunotherapy, we also need to keep in mind the prevalence of drug-induced inflammation. We also need to be careful with the upfront use of steroids (which I used to start at 20mg prednisone bid). There is data to support little change in the efficacy of immunotherapy with...

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How do you manage early and symptomatic fibrosis in lung cancer patients after RT?

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