Radiation Oncology/Dyspnea

Dyspnea and Pneumonitis

Supplemental oxygen

 * MDACC, 2003 - PMID 14694916 &mdash; "A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea." Bruera E et al. Palliat Med. 2003 Dec;17(8):659-63.
 * Randomized pts with advanced cancer without severe hypoxemia (SaO2 > 90%) at rest with dyspnea. Randomized to supplemental oxygen or air (5 L/min) by nasal cannula.
 * No significant difference in dyspnea, fatigue, or distance walked.

Pneumonitis

 * Management
 * From University of Pennsylvania Oncolink
 * Oral steroid therapy titrated over several weeks (Prednisone 60 mg/day x2 weeks, very slow taper over 3-12 weeks)
 * Pentoxifylilne could be considered to decrease progression to radiation fibrosis
 * May take 3-18 months for symptoms to fully resolve and/or stabilize. Any further significant improvement after 18 months is rare, due to progression to radiation fibrosis