Deterioration in lung function following hemithorax irradiation for pleural mesothelioma.
Thirty-four patients receiving high-dose hemithorax irradiation as part of the treatment for pleural mesothelioma were studied with regard to changes in lung function following irradiation, and these changes were correlated with the radiologically-assessed lung injury. The latter was scored from 0 to 500 and found to be severe by 6 months (mean score 360), very severe by 9 months (mean score 430), and nearly total by 12 months (mean score 480) after treatment. Forced vital capacity and diffusing capacity both showed a significant decline at 1.5-2 months following the end of radiotherapy and thereafter up to the end of the 1 year follow-up period. Neither of these variables could be correlated consistently with the radiologically-assessed changes. Hypoxemia and pathological physiological shunting increased transiently 1-2 months after irradiation in 2 of the 6 patients monitored. The observed radiologically-assessed final effects of high-dose hemithorax irradiation are compatible with a total loss of lung function on the irradiated side. Before this form of treatment is used, lung function should be evaluated as for pneumonectomy.
Maasilta
P
P
Department of Pulmonary Medicine, Helsinki University Central Hospital, Finland.
D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology* / Q000528:radiation effects*; D008297:Male; D008654:Mesothelioma / Q000532:radiotherapy*; D010997:Pleural Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000503:physiopathology*; D012129:Respiratory Function Tests; D014797:Vital Capacity