Table 2.

Changes in the lung after radiation therapy (Adapted from Clinical Oncology 8th edition)

		Dose (Gy)
Event	Time	0	5	9	13
Type II cell degranulation; surfactant release	1 h–7 days	–	–	–	+
Loss of basal laminar proteoglycans	1 h–7 days	–	±	+	++
Loss of alveolar macrophages	7 days	–	–	±	+
Surfactant recovery	4 weeks	–	–	–	+
Replacement of laminar proteoglycans	4–12 weeks	–	±	±	+
Radiation pneumonitis	12–30 weeks	–	–	–	+
Peak in soluble fibronectin	12–30 weeks	–	±	±	++
Fibrosis	30–60 weeks	–	±	+	+
Peak in insoluble fibronectin	30–60 weeks	–	+	+	++
Increased laminin	12–60 weeks	–	±	+	++

Modified from Penney DP: Ultrastructural organization of the distal lung and potential target cells of ionizing radiation. Paper presented at: International Conference on New Biology of Lung and Lung Injury and Their Implications for Oncology; 1987; Porvoo, Finland