[en] High-dosage irradiation is an important component in the treatment of patients with lung cancer. While most patients tolerate therapy well, certain changes can be expected in their bodies. The authors review these effects and offer suggestions for their management. 34 references

[en] A picosecond traveling-wave parametric device capable of controlled spectral bandwidth and wavelength in the infrared is reported. Intense 1.064 mu M picosecond pulses pass through a 4.5 cm long LiNbO³ optical parametric oscillator crystal set at its degeneracy angle. A broad band emerges, and a simple grating and mirror arrangement is used to inject a selected narrow-band into a 2 cm long LiNbO³ optical parametric amplifier crystal along a second pump line. Typical input energies at 1.064 mu M along both pump lines are 6-8 mJ for the oscillator and 10 mJ for the amplifier. This yields 1 mJ of tunable output in the range 1.98 to 2.38 mu M which when downconverted in a 1 cm long CdSe crystal mixer gives 2 mu J of tunable radiation over the 14.8 to 18.5 mu M region. The bandwidth and wavelength of both the 2 and 16 mu M radiation output are controlled solely by the diffraction grating

[en] Given the high cure rate of patients with Hodgkin's disease, the complications related to therapy take on great significance. Mantle irradiation to the thorax is used in virtually all patients with early stage Hodgkin's disease. Prior studies of patients receiving mantle irradiation demonstrated short-term (up to 24 months) abnormalities of pulmonary function. In the present study, we prospectively studied 13 patients for up to 60 months after irradiation only with serial pulmonary function tests, arterial blood gas tests, diffusing capacity of carbon monoxide, chest radiographs, and ventilation-perfusion scans. No respiratory symptoms attributable to therapy were noted. Frequent radiographic changes (62%) were found consisting of apical fibrosis, paramediastinal fibrosis, or pleural thickening. Two patients developed an asymptomatic spontaneous pneumothorax that resolved with conservative management. Ventilation-perfusion scans often (73%) revealed decreased perfusion to the lung apices with associated ventilatory deficits in one-half of these patients. Patients with intrathoracic disease had decreased lung volumes prior to therapy, and lung volumes did not change following irradiation. Lung mechanics were normal throughout the study. Gas exchange at rest was normal in patients with extrathoracic disease. Patients with intrathoracic disease often presented with an abnormal arterial PO2 and widened alveolar-arterial partial pressure gradient for oxygen. However, these parameters normalized by 9 months after therapy. Despite the frequent development of radiographic and V/Q scan abnormalities in the lung apices, patients tolerated mantle radiotherapy remarkably well. In fact, patients with intrathoracic disease demonstrated improved gas exchange at rest following therapy