title: Prospective prediction of post-radiation therapy lung function using quantitative lung scans and pulmonary function testing.
abstract: Surgeons have made use of quantitative perfusion lung scanning (QS) and forced expiratory volume in one second (FEV1) to predict a patient's ability to tolerate lung resection. In this study QS and FEV1 were used to predict prospectively pulmonary function following lung irradiation (XRT). Twenty-two patients have had QS and FEV1 determined before XRT and at planned intervals post-XRT. Serial determination of lung function post-XRT allows comment on the temporal nature of the XRT effect on lung function. Seventeen patients had QS and FEV1 determined at an interval of 2-6 months post-irradiation with a drop in the groups mean FEV1 from 1.91 to 1.87L. or 2% during that interval. In the interval from 6-12 months post-XRT, 13 patients had studies with the groups mean FEV1 dropping from 1.79 to 1.58L or 12% of the original. In the interval from 12-18 months, 6 patients had a decline in mean FEV1 from 1.73 to 1.56L. or 10% of the original. In 22 patients a predicted final FEV1 was compared with a measured value at an interval from XRT. Fourteen of these determinations were at intervals greater than 6 months from the start of XRT and 6 at intervals of greater than 1 year. FEV1 was seen to drop during the follow-up intervals toward the predicted value. In only 2 patients did the final FEV1 drop below the predicted FEV1 and never by more than 0.12L. (6%). In summary, a method for predicting post-XRT pulmonary function using QS and FEV1 is described. Serial follow-up revealed a latent period followed by a late phase where FEV1 fell toward, but not significantly below, the predicted value. Such a determination can be of value in formulating a treatment plan for patients with significantly diminished pulmonary function.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: J H
authors.initials: JH
authors.lastname: Rubenstein
authors.forename: M P
authors.initials: MP
authors.lastname: Richter
authors.forename: P J
authors.initials: PJ
authors.lastname: Moldofsky
authors.forename: L J
authors.initials: LJ
authors.lastname: Solin
mesh_terms: D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000528:radiation effects*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000532:radiotherapy*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012129:Respiratory Function Tests; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin