CASE REPORT article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1566693
This article is part of the Research TopicRecent Advances in Radiation Oncology for the Management of Thoracic MalignanciesView all 5 articles
Proximal bronchial injury in small-cell lung cancer patient after moderately hypofractionated radiotherapy
Provisionally accepted
- 1Department of Radiotherapy, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong Province, China
- 2Department of Radiotherapy, United Family Hospital Qingdao, No.319 Hongkong east Road, Qingdao 266000, Shandong Province, China., Qingdao, China
- 3Department of Oncology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences（Qingdao Central Hospital）, Qingdao, China
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Background: Proximal bronchial injury is a frequently observed complication in patients with central lung cancer following high-dose stereotactic body radiotherapy, whereas it is rarely reported after moderately hypofractionated radiotherapy. In this article, we present a case of proximal bronchial injury in a patient with small-cell lung cancer after moderately hypofractionated radiotherapy.A 45-year-old male patient with no history of smoking was diagnosed with limited stage small-cell lung cancer. According to guidelines of the National Comprehensive Cancer Network, the patient was treated with chemoradiotherapy, which included etoposide and cisplatin as well as radiotherapy at a dose of 65 Gy/26 fractions. Three months after radiotherapy, the tumor disappeared; however, stenosis of the right main bronchus, right upper lobe bronchus, and intermediate bronchus, as well as atelectasis of the right upper and middle lobes, occurred and gradually worsened. Anti-infection and hormonal therapy were ineffective. One year after radiotherapy, grade 3 damage was formed in the proximal bronchus according to the Common Terminology Criteria for Adverse Events (version 5.0). Following endoscopic balloon dilatation of the right main bronchus, asthma symptoms of the patient were reduced.This case reminds us that it is necessary to implement a proximal bronchial dose constraint and prevent the occurrence of dose hot spot in the proximal bronchus when administering moderately hypofractionated radiotherapy with a physical dose exceeding 65 Gy.
Keywords: small-cell lung cancer, Proximal bronchial tree, Moderately hypofractionated radiotherapy, Radiation-induced airway disease, Atelectasis, Bronchial stenosis
Received: 25 Jan 2025; Accepted: 25 Apr 2025.
Copyright: © 2025 Zhang, Yun, Wang, Yan, Dai, Qu, Yang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aijie Yang, Department of Radiotherapy, Qilu Hospital of Shandong University (Qingdao), Qingdao, 266035, Shandong Province, China
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