Single-Cell Sequencing Analysis of Radiation Pneumonitis Signals In Patients Treated For Cancer With Radiotherapy

Inclusion Criteria: * Age over 18 years * Patient has received thoracic radiotherapy and has clinical or radiological features in fitting with a diagnosis of Radiation Pneumonitis (onset one to four months post-RT with breathlessness, especially exertional, cough, chest discomfort, which is persistent over weeks, a chest x-ray \[CXR\] may demonstrate patchy or widespread opacification although can be normal.) * Must be ambulant, oxygen independent with SpO2 \>92% on air and haemodynamically stable to be considered safe for a bronchoscopy. * Willing to undergo and likely able to tolerate bronchoscopy, ie. Can lie flat without compromising ventilation, and able to consent to the ELFMAN Protocol and SPITFIRE trial. Exclusion Criteria: * Contraindication to bronchoscopy, ie. Previously not tolerated, unable to lie flat, Sp02 \<92% on air * Patient requires admission or oxygen dependant * Test positive for Covid-19 within the preceding six weeks to enrolment