Not all animal models develop radiation-induced pleural effusions (RIPEs) as a form of radiation-induced lung injury (RILI). Such effusions are also not well characterized in humans. The purpose of this study is to identify occurrences of RIPE in humans, provide justification for development of relevant animal models, and further characterize its risk factors in cancer patients. We also aim to identify dose thresholds for cardiopulmonary toxicity in humans to shed light on possible pathogenic mechanisms for RIPEs. We carried out a retrospective review of medical records of 96 cancer patients receiving thoracic irradiation (TRT) at our institution. Fifty-three (53%) patients developed a new pleural effusion post TRT; 18 (19%) had RIPE; and 67% developed RIPE ipsilateral to the site irradiated. None developed "contralateral only" effusions. Median time to development was 6 mo (IQR; 4-8 mo). Of 18, 8 patients (44%) had concomitant asymptomatic (radiographic only) or symptomatic radiation pneumonitis and pericardial effusion. Dosimetric factors, including combined and ipsilateral mean lung dose (MLD), were significantly associated with increased risk of RIPE. Angiotensin converting enzyme inhibition, steroids, or concurrent chemotherapy did not modify incidence of RIPE. Our results substantiate the occurrence and incidence of RIPEs in humans. In cancer patients, a median time to development of effusions around 6 mo also supports the onset of RIPEs concurrent with radiation pneumonitis. Future work needs to include large populations of cancer survivors in whom delayed RIPEs can be tracked and correlated with cardiovascular changes in the context of injury to multiple organs.

中文翻译：

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评估放疗后辐射引起的胸腔积液以支持放射性肺炎动物模型的开发。

并非所有动物模型都会将辐射引起的胸腔积液 (RIPE) 作为辐射引起的肺损伤 (RILI) 的一种形式。这种积液在人类身上也没有得到很好的表征。本研究的目的是确定人类中 RIPE 的发生情况，为相关动物模型的开发提供依据，并进一步描述癌症患者中 RIPE 的危险因素。我们还旨在确定人类心肺毒性的剂量阈值，以揭示 RIPE 可能的致病机制。我们对在我们机构接受胸部照射 (TRT) 的 96 名癌症患者的病历进行了回顾性审查。53 名 (53%) 患者在 TRT 后出现新的胸腔积液；18（19%）有 RIPE；67% 的受照射部位同侧出现 RIPE。没有人出现“仅对侧”积液。中位发育时间为 6 个月（IQR；4-8 个月）。在 18 名患者中，8 名患者 (44%) 伴有无症状（仅放射学检查）或有症状的放射性肺炎和心包积液。剂量学因素，包括组合和同侧平均肺剂量 (MLD)，与 RIPE 风险增加显着相关。血管紧张素转换酶抑制、类固醇或同步化疗不会改变 RIPE 的发生率。我们的结果证实了人类中 RIPE 的发生和发生率。在癌症患者中，出现积液的中位时间约为 6 个月，这也支持 RIPE 与放射性肺炎同时发生。未来的工作需要包括大量癌症幸存者，在这些幸存者中，可以追踪延迟的 RIPE，并将其与多器官损伤情况下的心血管变化相关联。