Chest and thorax: Symptoms and toxicities

In the last several decades, cancer-related treatment has significantly advanced including increased utilization of immunotherapy, improvement in surgical precision and radiation techniques, palliative medicine, and emphasis on patient quality of life. Increasing treatment of metastatic disease and oligometastases has been emphasized including treatment of oligometastatic pulmonary disease. Many of the world’s most common cancers commonly metastasize to the lung parenchyma including breast, lung, colorectal, uterine leiomyosarcoma, and head and neck squamous cell carcinomas. Cancer commonly spreading to the endobronchial tree includes colorectal, renal, lung, and lymphoma. Additionally, common urgent radiation diagnoses including superior vena cava syndrome and malignant airway obstruction cause similar short- and long-term side effects. It is therefore of utmost importance to understand, recognize and treat palliative radiation therapy complications, both acute and chronic, as it pertains to the thorax. In this chapter, we discuss common acute and chronic toxicities of the thorax, including the most common presentations, diagnosis, common terminology criteria for adverse events (CTCAE) grading, prevalence, and management.