Lung function following treatment of malignant tumors with surgery, radiotherapy, or cyclophosphamide in childhood. A follow-up study after 11 to 27 years
✍ Scribed by Anne Mäkipernaa; Matti Heino; Lauri A. Laitinen; Martti A. Siimes
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 493 KB
- Volume
- 63
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
A group of 40 individuals were restudied at a median follow-up time of 18 years after chest surgery, chest irradiation, or cyclophosphamide treatment. Their median age at diagnosis was 4.5 years. Nineteen subjects were operated on in the chest area. Radiotherapy of the chest had been used in 21 and cyclophosphamide in 35 patients. Chest deformity was evident in 17 subjects. Chest radiographs showed some evidence of fibrosis in eight subjects and late effects of surgery in three subjects. In nine subjects some evidence of fixed obstruction was seen in spirometry. In three subjects pulmonary diffusion capacity was abnormal. Spirometry commonly showed a restrictive pattern of findings. The incidence of abnormalities in pulmonary function was highest among the patients diagnosed before age 3 years. Spirometry was more likely to reveal abnormalities in patients who had received irradiation to the chest. However, abnormalities in pulmonary function were fewer than anticipated.
Cancer 63:625-630, 1989.
ONG-TERM FOLLOW-UP of children treated for various L types of solid tumors has focused attention upon the lung function complications that may be a sequel of chest irradiation, chest surgery, and chemotherapy in childhood.
The mutilative complications that are seen today are the results of the methods of chest surgery used in the 1960s. The high doses of cyclophosphamide have associated with potential heart and lung damage.132 In the 1960s and early 1970s other chemotherapeutic agents (nitrosoureas) were also used.3 Their late complications are less well known than the problems encountered after cyclophosphamide treatment, because the follow-up times are as yet inadequate.
We had an opportunity to investigate the lung function complications in 40 patients who received either chest irradiation or cyclophosphamide or both for neuroblastoma, Hodgkin's disease, sarcoma, lymphoma, or Wilms' tumor.
Patients and Methods
Of the over 400 children admitted to the Children's Hospital, University of Helsinki, Finland, for diagnosis