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Radiation pneumonitis is seen in 5 to 15 percent of patients irradiated for breast, lung, and mediastinal tumors. 18 The risk of developing radiation pneumonitis is directly related to the volume of irradiated lung, the amount of radiation given, and the use of concurrent chemotherapy. 18 Additional risk factors include comorbid lung disease, poor baseline pulmonary function testing, and low Karnofsky performance score. 19 Opinions vary regarding the effect of smoking. Some studies identify smoking as a risk for pneumonitis,19 whereas others suggest smoking may lessen the risk. Symptoms of radiation pneumonitis, including low-grade fever, congestion, dry cough, pleuritic chest pain, and a sensation of chest fullness, usually develop one to three months after completion of radiation therapy.

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