Pulmonary function abnormalities in children treated with whole lung irradiation.
BACKGROUND
We sought to determine the prevalence of abnormal pulmonary function tests (PFTs) in a cohort of children who had received whole lung irradiation (WLI) for treatment of metastatic disease.


METHODS
This was a retrospective (1988-2003) chart review that included all children treated at our institution with WLI who had undergone PFT. Data abstracted included oncologic diagnosis, radiation dose and fractionation, spirometry (FVC, FEV1, FEV1/FVC, FEF25%-75%), plethysmography (TLC, FRC, RV, RV/TLC), diffusing capacity (DLCO), and respiratory muscle strength (MIP, MEP). PFTs were normalized according to standard deviation (Z) scores.


RESULTS
Thirty patients were identified who had one or more PFT. The incidence of mild, moderate, or severe reductions in FEV1 was 30%, 10%, and 10%, respectively, with 50% having normal FEV1. Seventeen percent of patients had mild reduction in total lung capacity (TLC), while 13% and 30% had moderate or severe reductions. Thirty-eight percent had mild reductions in diffusing capacity, while 29% and 14% had moderate or severe reductions.


CONCLUSIONS
Pulmonary function abnormalities were common in this cohort of children treated with WLI, and may be progressive in nature. Further studies are warranted to identify patients at highest risk.
Weiner
Daniel J
DJ
Department of Pediatrics, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA. weiner@email.chop.edu
Maity
Amit
A
Carlson
Claire A
CA
Ginsberg
Jill P
JP
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008168:Lung / Q000473:pathology / Q000503:physiopathology*; D055370:Lung Injury; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014109:Total Lung Capacity / Q000528:radiation effects