International Journal of Radiation Research

en Clinical evaluation of acute lung injury in patients with severe pneumonia after radiotherapy: A respiratory system perspective Radiation Biology Radiation Biology <div style="text-align: justify;">Background: Acute lung injury (ALI) in patients with severe pneumonia after thoracic radiotherapy is a clinical problem, because infectious infiltrates may overlap radiation-induced lung changes. The present study aimed to investigate the clinical characteristics, radiological findings, inflammatory markers and outcomes in this population. Materials and Methods: A prospective observational study of 68 adults with severe pneumonia, prior thoracic radiotherapy, and concurrent ALI at a tertiary teaching hospital from January to December 2024. ALI severity was classified using PaO2/FiO2 ratios according to the Berlin definition. Clinical variables, inflammatory markers, chest imaging findings, respiratory-support requirements, intensive care unit (ICU) admission and in-hospital mortality were evaluated. Results: Mild, moderate and severe ALI was seen in 45.6%, 47.0% and 7.3% of patients respectively. Radiation and organizing pneumonia patterns of fibrosis were observed in 32.4% and 20.6% of patients, respectively. Mean C-reactive protein concentrations were higher in patients with consolidation (129.2 mg/L), patchy opacities (124.4 mg/L) and lower in patients with radiation fibrosis (78.3 mg/L). ICU admission was required in 50% of patients and invasive mechanical ventilation in 45.6%. In-hospital mortality was 25.0% overall. None of the predictors evaluated were statistically significant in the multivariate mortality model. Conclusion: Severe pneumonia with ALI after thoracic radiotherapy is associated with overlapping infectious and radiation-related radiological findings, substantial critical-care requirements, and substantial in-hospital mortality. Early recognition and integrated assessment of oxygenation, inflammatory markers and imaging findings may support clinical risk stratification.</div> Acute lung injury (ALI), radiation pneumonitis, severe pneumonia, radiotherapy, inflammatory markers, ICU outcomes. 987 995 http://ijrr.com/browse.php?a_code=A-10-1-1607&slc_lang=en&sid=1 Q. Zhu 7900319475328460034853 7900319475328460034853 No Department of Emergency Medicine, The First People's Hospital of Jiashan, Jiashan, Zhejiang Province, China G. Zhou 7900319475328460034854 7900319475328460034854 No Department of ICU, Jinhua Municipal Central Hospital Medical Group, Jinhua, Zhejiang Province, China S. Wan 7900319475328460034855 7900319475328460034855 No Department of Thoracic, Jiangxi Cancer Hospital, Nanchang, Jiangxi Province, China S. Jiang 7900319475328460034856 7900319475328460034856 No Department of Emergency Medicine, The First People's Hospital of Jiashan, Jiashan, Zhejiang Province, China J. Jiang 7900319475328460034857 7900319475328460034857 No Department of ICU, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan Province, China F. Shen 7900319475328460034858 7900319475328460034858 No Department of General Medicine, Pingshan Community Health Service Center, Headquarters of Nanshan Medical Group, Shenzhen 518051, Guangdong Province, China Q. Wang w683507@163.com 7900319475328460034859 7900319475328460034859 Yes Department of Emergency Medicine, The First People's Hospital of Jiashan, Jiashan, Zhejiang Province, China