Pulmonary function after whole lung irradiation in pediatric patients with solid malignancies

被引:24
作者
Motosue, Megan S. [1 ]
Zhu, Liang [2 ]
Srivastava, Kumar [2 ]
Stokes, Dennis C. [3 ,4 ]
Hudson, Melissa M. [1 ,3 ]
McPherson, Valerie [1 ]
Srinivasan, Saumini [3 ,4 ]
Krasin, Matthew J. [5 ]
Green, Daniel M. [1 ,3 ]
Spunt, Sheri L. [1 ,3 ]
Inaba, Hiroto [1 ,3 ]
机构
[1] St Jude Childrens Res Hosp, Dept Oncol, Memphis, TN 38105 USA
[2] St Jude Childrens Res Hosp, Dept Biostat, Memphis, TN 38105 USA
[3] Univ Tennessee Hlth Sci Ctr, Dept Pediat, Memphis, TN USA
[4] St Jude Childrens Res Hosp, Program Pediat Pulm Med, Memphis, TN 38105 USA
[5] St Jude Childrens Res Hosp, Dept Radiol Sci, Memphis, TN 38105 USA
基金
美国国家卫生研究院;
关键词
pulmonary function tests; solid tumor; whole lung irradiation; pediatric cancer; follow-up; CHILDHOOD-CANCER SURVIVOR; SMOKING-CESSATION; REFERENCE VALUES; WILMS-TUMOR; CAPACITY; SMOKERS; ASTHMA;
D O I
10.1002/cncr.26371
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Although whole lung irradiation is used to treat pulmonary metastases of pediatric solid malignancies, few studies have addressed its long-term pulmonary consequences. METHODS: The authors conducted a retrospective study of longitudinal changes in 171 pulmonary function tests (PFTs) and their relation with clinical features in 48 survivors of pediatric malignant solid tumors treated with whole lung irradiation. RESULTS: Although active respiratory symptoms were seen in only 9 patients (18.8%), abnormalities in forced vital capacity (FVC; 58.3%), forced expiratory volume in 1 second (FEV1; 64.6%), total lung capacity (TLC; 72.9%), and diffusion capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr; 70.8%) were common. At a median follow-up of 9.7 years after whole lung irradiation, FVC, FEV1, and TLC significantly declined longitudinally (P = .04, .03, and .02, respectively). Focal pulmonary boost irradiation was significantly associated with abnormal FEV1/FVC (P = .03), forced expiratory flow between 25% and 75% forced vital capacity (P = .005), residual volume (RV; P = .005), and RV/TLC (P = .002). Ten patients had baseline PFTs, and FVC, FEV1, TLC, and DLCOcorr worsened immediately after radiation, followed by transient improvement but subsequent decline. Thirteen of 32 (40.6%) patients aged >18 years were smokers. CONCLUSIONS: Pulmonary dysfunction was prevalent after whole lung irradiation and worsened over time, although most patients were asymptomatic. Boost irradiation impaired pulmonary function, and a significant proportion of patients were smokers. Further studies are planned to assess the predictors and clinical consequences of progressive PFT abnormalities and to evaluate educational interventions. Cancer 2012; 118: 1450-6. (C) 2011 American Cancer Society.
引用
收藏
页码:1450 / 1456
页数:7
相关论文
共 26 条
  • [1] Radiation-induced and chemotherapy-induced pulmonary injury
    Abid, SH
    Malhotra, V
    Perry, MC
    [J]. CURRENT OPINION IN ONCOLOGY, 2001, 13 (04) : 242 - 248
  • [3] [Anonymous], 2006, GLIMMIX PROCEDURE
  • [4] Respiratory effects of relocating to areas of differing air pollution levels
    Avol, EL
    Gauderman, WJ
    Tan, SM
    London, SJ
    Peters, JM
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 164 (11) : 2067 - 2072
  • [5] EFFECTS ON PULMONARY-FUNCTION OF WHOLE LUNG IRRADIATION FOR WILMS TUMOR IN CHILDREN
    BENOIST, MR
    LEMERLE, J
    JEAN, R
    RUFIN, P
    SCHEINMANN, P
    PAUPE, J
    [J]. THORAX, 1982, 37 (03) : 175 - 180
  • [6] Bölling T, 2008, STRAHLENTHER ONKOL, V184, P193, DOI 10.1007/s00066-008-1810-x
  • [7] Effects of smoking cessation on lung function and airway inflammation in smokers with asthma
    Chaudhuri, Rekha
    Livingston, Eric
    McMahon, Alex D.
    Lafferty, Jane
    Fraser, Iona
    Spears, Mark
    McSharry, Charles P.
    Thomson, Neil C.
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2006, 174 (02) : 127 - 133
  • [8] Asthma, influenza, and vaccination
    Glezen, W. Paul
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2006, 118 (06) : 1199 - 1206
  • [9] Household smoking and childhood asthma in the United States: A state-level analysis
    Goodwin, Renee D.
    Cowles, Robert A.
    [J]. JOURNAL OF ASTHMA, 2008, 45 (07) : 607 - 610
  • [10] Spirometric reference values from a sample of the general US population
    Hankinson, JL
    Odencrantz, JR
    Fedan, KB
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 159 (01) : 179 - 187