DOI QR코드

DOI QR Code

Preliminary Study for Development of Pattern Identification Tool for Radiation Pneumonitis

방사선폐렴 변증(辨證)도구 개발을 위한 기초연구

  • Kim, Jae-hyo (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Bhang, Yeon-hee (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Do, Ha-yoon (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Ahn, Jun-mo (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Kim, Kwan-il (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Lee, Beom-joon (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Jung, Sung-ki (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Jung, Hee-jae (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University)
  • 김재효 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 방연희 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 도하윤 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 안준모 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 김관일 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 이범준 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 정승기 (경희대학교대학원 임상한의학과 폐계내과학교실) ;
  • 정희재 (경희대학교대학원 임상한의학과 폐계내과학교실)
  • Received : 2017.02.22
  • Accepted : 2017.03.30
  • Published : 2017.03.30

Abstract

Objective: The purpose of this study was to develop a standard tool for pattern identification of radiation pneumonitis. Methods: Textbooks, published studies, and references with comments about patterns were reviewed. Through the Delphi method, we determined pattern identifications based on advice from a committee of experts composed of 13 Korean respiratory internal medicine professors. Results: Using the Delphi method, four pattern identifications were chosen: Qi Deficiency (氣虛), Yin Deficiency (陰虛), Heat Toxin (熱毒), and Phlegm Dampness (痰濕). The tool was developed in a question-and-answer format with 35 questions. Conclusions: A pattern identification tool that can discriminate the patterns of radiation pneumonitis for standardized diagnosis was developed through expert consultation. Further study of its validity and reliability is necessary.

Keywords

References

  1. Stephens KE, Ishizaka A, Larrick JW, Raffin TA. Tumor necrosis factor causes increased pulmonary permeability and edema: Comparison to septic acute lung injury. Am Rev Respir Dis 1988;137:1364-70. https://doi.org/10.1164/ajrccm/137.6.1364
  2. Henkenberens C, Janssen S, Lavae-Mokhtari M, Leni K, Meyer A, Christiansen H, et al. Inhalative steroids as an individual treatment in sysptomatic lung cancer patients with radiation pneumonitis grade II after radiotherapy - a single-centre experience. Radiat Oncol 2016;11(12):1-8. https://doi.org/10.1186/s13014-015-0579-1
  3. Movsas B, Raffin TA, Epstein AH, Link CJ Jr. Pulmonary radiation injury. Chest 1997;111(4): 1061-76. https://doi.org/10.1378/chest.111.4.1061
  4. Graham MV, Purdy JA, Emami B, Harms W, Bosch W, Lockett MA, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small-cell lung cancer(NSCLC). Int J Radiat Oncol Biol Phys 1999;45:323-9.
  5. Lee JH, Hyun IG, Choi DC, Yu CG, Song JH, Jung KS, et al. The Clinical Characteristics of Radiation Pneumonitis. Korean J Intern Med 1991;40(3):386-92.
  6. Ozturk B, Egehan I, Atavci S, Kitapci M. Pentoxifylline in prevention of Radiation-induced lung toxicity in patients with breast and lung cancer: A double-blind randomized trial. Int J radiation Oncology Biol Phys 2004;58(1):213-9. https://doi.org/10.1016/S0360-3016(03)01444-5
  7. Weytjens R, Erven K, De Ruysscher D. Radiation pneumonitis: occurrence, prediction, prevention and treatment. Belg J Med Oncol 2013;7(4):105-10.
  8. De Vries M, Berendsen AJ, Bosveld HE, Kerstjens HA, van der Molen T. COPD exacerbations in general practice: variability in oral prednisolone courses. BMC Fam Pract 2012. doi:10.1186/1471-2296-13-3.
  9. Steen NE, Methlie P, Lorentzen S, Hope S, Barrett EA, Larsson S. Increased systemic cortisol metabolism in patients with schizophrenia and bipolar disorder: a mechanism for increased stree vulnerability. J Clin Psychiatry 2011;72(11): 1515-21. https://doi.org/10.4088/JCP.10m06068yel
  10. Choi NC. Radioprotective Effect of Amifostine in Radiation Pneumonitis. Semin Oncol 2003; 30(6):10-7. https://doi.org/10.1016/S0093-7754(03)70020-7
  11. Molteni A, Moulder JE, Cohen EF. Control of radiation-induced pneumopathy and lung fibrosis by angiotensin-converting enzyme inhibitors and an angiotensin II type 1 receptor blocker. Int J Radiat Biol 2000;76:523-32. https://doi.org/10.1080/095530000138538
  12. Gao F, Fish BL, Moulder JE. Enalapril mitigates radiation-induced pneumonitis and pulmonary fibrosis if started 35 days after whole-thorax irradiation. Radiat Res 2013;180:546-52. https://doi.org/10.1667/RR13350.1
  13. Osterreicher J, Mokry J, Navratil L. The alveolar septal thickness and type II pneumocytes number in irradiated lungs, time expression and the effect of pentoxifylline. Acta Medica 2001;44:15-9
  14. Li J, Chen J, Qian YF. Effects of Yiqi Yangyin Method on Radiation-induced Acute Lung Injure. Liaoning J Tradit Chin Med 2012;9:1767-9.
  15. 張鹏, 胡志敏. 胡志敏教授運用經方辨証治療放射性肺炎的經驗總結. Medical Recapitulate. 2004; 14(3):478.
  16. 陳清華. "健脾潤肺湯"治療放射性肺炎32例臨床觀察. Jiangsu J Tradit Chin Med 2011;11:31.
  17. 張霆, 潘曉蟬. 金水相生法治療放射性肺炎証治擧隅. New J Tradit Chin Med 2005;37(10):87.
  18. Chae J, Lee JY, Song AN, Choi SH, Lee SM, Jung YH, et al. Effect of Saengmaek-san on Cancer Patients with Symptoms Related to Radiation Pneumonitis after Radiotherapy: Report of 2 Cases. J Kor Tradit Oncol 2013; 18(1):1-7.
  19. Baizhen LU, Weimin MAO, Chunlei WANG, Qiong WANG, Yaping XU, Nengming LIN, et al. Review of traditional Chinese medicine treating radiation pneumonitis. Chin Arch Tradi Chin Med 2013;31(3):533-5.
  20. 勾承鵠, 楊彩周, 百合固金湯加味治療放射性肺炎 114例. J Sichuan Tradit Chin Med 2003;21(12): 38-9.
  21. 郝靜, 鄭國寶, 張建國, 趙偉. 百合麥冬湯加減聯 合激素及抗生素治療放射性肺炎的臨床觀察. Guide of China Medicine 2010;8(34):251-2.
  22. 趙孟春. 益肺煎治療放射性肺炎41例臨床觀察. Clin J Tradit Chin Med 2010;22(5):400-1.
  23. Rao FU, Kong LL. 清燥救肺湯預防和治療放射 性肺炎的臨床觀察. Guide of China Medicine 2011;29.
  24. 廖震, 胡春申. 潤肺清熱方治療放射性肺炎60例療效觀察. J Emergency Tradit Chin Med 2008; 17(1):18-9.
  25. 閆冰川, 蘇旭春, 吳迪, 孔嘉欣, 梁傍順, 劉錦全. 生脈二陳湯治療放射性肺損傷臨床觀察. J New Chin Med 2011;43(5):52-53.
  26. Wang LL, Song EF. Meta Analysis of Integrative Medicine in Treating Radiation Pneumonitis. Guiding J Tradit Chin Med Pharm 2014;20(16): 47-50.
  27. Yin SY, Wei WC, Jian FY, Yang NS. Therapeutic applications of herbal medicines for cancer patients. Evid Based Complement Alternat Med 2013:1-15.
  28. 李兆元, 餘海英, 寧四清, 易鐵男. 參麥注射液聯 合氨溴索治療急性放射性肺炎48例臨床觀察. J Clin Pulm Med 2012;17(1):141-2.
  29. Qi F, Zhao L, Zhou A, Zhang B, Li A, Wang Z, et al. The advantages of using traditional Chinese medicine as an adjunctive therapy in the whole course of cancer treatment instead of only terminal stage of cancer. Biosci Trends 2015;9(1):16-34. https://doi.org/10.5582/bst.2015.01019
  30. Jiang ZH, Wang DF, Chen SD, Jiang QJ. 82 Cases of Radiation Pneumonia Treated by Shendong Xihuang Decoction and Western Medicine. J Nanjing Univ Tradit Chin Med 2011;27(5):533-5.
  31. 劉良麗, 張葵, 歐江琴, 李源清. 放射性肺炎的辨治 心得. J Sichuan Tradit Chin Med 2006;24(4) :30-2.
  32. 黄火文, 張蓓 主编, 中西医結合治療. 肿瘤病. 广州: 广東人民出版社; 2000, p. 27-2743.
  33. 張蓓, 周志偉. Practical Oncology of Integrated Traditional Chinese and Western Medicine. 广州: 广東人民出版社; 2004, p. 198-9.
  34. 陈銳深. 現代中醫腫瘤學. 北京: 人民衛生出版社; 2003, p. 167-8.
  35. 周宜强. 實用中医肿瘤學. 北京: 中医古籍出版社; 2006.
  36. 吳心芳, 徐保宁. 放射性肺炎的辨治概要. Jiangsu J Tradit Chin Med 2002;23(3):15.
  37. 珙汲鋒, 傳藏紅, 王瑾, 王永蘭. 放射性肺炎的中医辨証治療及辨証施護. Gangsu J Tradit Chin Med 2008;21(12):34.
  38. 趙鳳達, 谢建祥. 辨証治療放射性肺炎的体會. China J Tradit Chin Med Pharm 2001;16(3):46-7.
  39. GaoPing. 辨証論治放射性肺炎及放射性膀胱炎的經驗体會. J Guiyang College Tradit Chin Med 2005;27(2):34-5.
  40. Xu Hang. 辨証論治联合放射治療老年食管癌60例, Chin Med Mod Dist Edu China 2015;13(14):72-3.
  41. 王辉. 中医辨証論治放射性肺炎17例. World Latest Med Inform 2013;17:246.
  42. 門炜, 贾英杰. 贾英杰教授辨証治療放射性肺炎經驗. Mod J Integ Tradit Chin West Med 2010; 19(15):1889-90.
  43. 王安, 林胜友, 許遠. 林胜友辨証論治放射性肺炎經驗. Zhejiang J Tradit Chin Med 2014;49(6):450.
  44. Bentzen SM. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nature Reviews Cancer 2006;6(9):702-13. https://doi.org/10.1038/nrc1950
  45. Giridhar P, Mallick S, Rath GK, Julka PK. Radiation induced lung injury: prediction, assessment and management. Asian Pac J Cancer Prev 2015;16(7):2613-7. https://doi.org/10.7314/APJCP.2015.16.7.2613
  46. Zhang XJ, Sun JG, Sun J, Ming H, Wang XX, Wu L, et al. Prediction of radiation pneumonitis in lung cancer patients: a systematic review. Journal of Cancer Res Clin Oncol 2012;138(12): 2103-16. https://doi.org/10.1007/s00432-012-1284-1
  47. Lee JG, Rho BH, Chang JC. Imaging Feature of Radiation Induced Lung Disease. Yeungnam Uni J of Med 2000;17(2):146-54. https://doi.org/10.12701/yujm.2000.17.2.146
  48. Kocak Z1, Evans ES, Zhou SM, Miller KL, Folz RJ, Shafman TD, et al. Shafman Timothy D. Marks et al. Challenges in defining radiation pneumonitis in patients with lung cancer. Int J Rad Oncol Biol Phys 2005;62(3):635-8. https://doi.org/10.1016/j.ijrobp.2004.12.023
  49. Hong JH, Kang JY, Kim TJ, Lee JH, Kim DW, Yoon HK, et al. A Case of Bronchiolitis Obliterans Organizing Pneumonia after Radiation Therapy in Breast Cancer. Korean J Med 2011;80(4):458-63.
  50. McDonald S, Rubin P, Phillips TL, Marks LB. Injury to the lung from cancer therapy: Clinical syndromes, measurable endpoints, and potential scoring systems. Int J Rad Oncol Biol Phys 1995;31(5):1187-203. https://doi.org/10.1016/0360-3016(94)00429-O
  51. Benveniste MF, Welsh J, Godoy MC, Betancourt SL, Mawlawi OR, Munden RF. New era of radiotherapy: an update in radiation-induced lung disease. Clin Radiol 2013;68(6):e275-90. https://doi.org/10.1016/j.crad.2013.01.013
  52. Xiao C, Ding HJ, Feng LC, Qu BL, Dou YQ. Efficacy of Liangxue Jiedu Huoxue Decoction in prevention of radiation pneumonitis: a randomized controlled trial. Zhong Xi Yi Jie He Xue Bao 2010;8(7):624-8. https://doi.org/10.3736/jcim20100704
  53. Hillman GG, Singh-Gupta V, Lonardo F, Hoogstra DJ, Abernathy LM, Yunker CK, et al. Radioprotection of Lung Tissue by Soy Isoflavones. J Thorac Onol 2013;8(11):1356-64. https://doi.org/10.1097/JTO.0b013e3182a4713e
  54. Kim KI, Shin SW, Lee NL, Lee BJ, Jung HJ, Jung SK, et al. Preliminary Study for Development of Pattern Identification Tool of Chronic Cough. J Int Korean Med 2015;36(1):22-39. https://doi.org/10.13048/jkm.15003