Radiation Oncology/Dyspnea

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Dyspnea and Pneumonitis

Dyspnea

Supplemental oxygen

MDACC, 2003 - PMID 14694916 — "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

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