A prospective study of pulmonary function in Hodgkin's lymphoma patients.
BACKGROUND
To prospectively study changes in lung function in Hodgkin's lymphoma (HL) patients and to explore predictors for these changes over time.


METHODS
In all, 52 patients with HL receiving bleomycin-based chemotherapy with (n = 23) or without (n = 29) mediastinal radiotherapy were enrolled. Pretreatment pulmonary function tests were carried out. These were repeated at 1 month, 6 months, and 1 year after therapy.


RESULTS
With chemotherapy alone, the median %DLCO declined significantly at 1 month but returned to baseline by 6 months. The median %DLCO did not further decrease with radiotherapy, but remained persistently reduced at 1 year. In patients who received radiotherapy, having >33% of lung volume receive 20 Gy (V20) and a mean lung dose (MLD) of >13 Gy significantly predicted for persistently reduced %DLCO at 6 months (P = 0.035). Smoking significantly predicted for a persistently reduced %DLCO at 1 year (P = 0.036). On multivariable analysis, significant predictors for decline in %DLCO at 1 year were higher baseline %DLCO (P = 0.01), higher MLD (P = 0.02), and a smoking history (P = 0.02).


CONCLUSIONS
Several factors contribute to decline in %DLCO in HL patients who received bleomycin-based computed tomography. The identification of threshold radiation dosimetric parameters for reduced lung function may provide guidance in the radiation planning of these patients.
Ng
A K
AK
Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA 02114, USA. ang@lroc.harvard.edu
Li
S
S
Neuberg
D
D
Chi
R
R
Fisher
D C
DC
Silver
B
B
Mauch
P M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology* / Q000528:radiation effects; D008171:Lung Diseases / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology
D001761:Bleomycin