International Journal of Radiation Research

en Radiation-induced lung injury in lung cancer patients with coexisting chronic obstructive pulmonary disease or asthma: Systematic review about mechanisms, risks, and management advances Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: Thoracic irradiation for lung cancer (small cell and non-small cell) has one major dose-limiting effect: radiation-induced lung damage (RILI). For patients with lung cancer and chronic obstructive pulmonary disease (COPD) or asthma, this review compiles the latest research on RILI's causes, risk factors, and treatment options. Materials and Methods: A systematic literature search was conducted following PRISMA 2020 guidelines. Search MESH terms combined: "RILI," "radiation pneumonitis," "pulmonary fibrosis," "COPD," "asthma," "lung cancer," and "radiotherapy." Data extraction focused on patient characteristics, radiotherapy parameters, RILI incidence, underlying mechanisms, and management outcomes. Results: Out of 847 publications, 38 met the inclusion criteria and contained 12,847 patients, with 11,942 suffering from COPD and 905 with asthma. While no significant association was found with asthma (pooled OR 1.12, 95% CI 0.89-1.41, p=0.32), an analysis of 12 studies showed that individuals with COPD had a significantly higher risk of RILI (pooled OR 2.14, 95% CI 1.78-2.56, p<0.001). Lungs affected by COPD showed signs of a quick change from epithelial to mesenchymal cells, an imbalance in TGF-β signaling, heightened reactions to oxidative stress, and impaired capacity to repair DNA. Novel biomarkers for the early detection of RILI, lung density-guided radiation planning, statin medication, and inhibitors of the renin-angiotensin system are all part of the most recent advancements in treatments. Conclusion: Personalized radiotherapy planning incorporating baseline lung function, novel radioprotective agents, and early biomarker surveillance may optimize outcomes in this vulnerable population. Harmonized protocols for RILI assessment and management are urgently needed.</div> Radiation-induced lung injury (RILI), chronic pulmonary diseases (COPD, Asthma), pathophysiological mechanisms, imaging biomarkers, pulmonary function tests, management strategies. 1069 1079 http://ijrr.com/browse.php?a_code=A-10-1-1617&slc_lang=en&sid=1 F.J. Liu 7900319475328460034983 7900319475328460034983 No Clinical Trial Research Center, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China Y. Wang 7900319475328460034984 7900319475328460034984 No Clinical Trial Research Center, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China S. Sui 7900319475328460034985 7900319475328460034985 No Clinical Trial Research Center, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China F. Xu 7900319475328460034986 7900319475328460034986 No Primary Healthcare Department, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China X.N. Sun 7900319475328460034987 7900319475328460034987 No Nursing Department, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China J.J. Han wf-hjj@163.com 7900319475328460034988 7900319475328460034988 Yes Medical Affairs Department, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China