title: Correlation of pulmonary function abnormalities with dose volume histograms in children treated with lung irradiation.
abstract: BACKGROUND
  There is limited data on pulmonary function test (PFT) abnormalities in children treated with modern irradiation techniques. PFT abnormalities have not been correlated with the dose and volume of irradiation.
  
  
  METHODS
  A retrospective chart review of PFTs and clinical outcomes in children who received radiation therapy (RT) at Children's Hospital Los Angeles between 1999 and 2009 was performed. Radiation dose distribution to normal lung tissue was calculated.
  
  
  RESULTS
  Forty-nine patients had PFTs available post-RT at a median time of 2.91 years (range, 0.01-8.28) from irradiation. Sixty-seven percent of patients had at least one PFT abnormality on their last available study. The most common abnormality was obstructive lung disease (24%) followed by hyperinflation (20%). Thoracic surgery prior to RT increased the odds of an abnormal FEV1, RV/TLC, and obstructive disease. The sex of the patient, age at the time of irradiation, and time of the PFT after irradiation did not have a significant association with abnormalities. The mean lung dose, maximum lung dose, and prescribed dose of radiation were significantly associated with the development of PFT abnormalities. The odds of developing an abnormal PFT increased with increase in the minimum threshold dose (V(dose)) of radiation, mostly above V(20).
  
  
  CONCLUSIONS
  PFT abnormalities are common even when modern radiation techniques are used. A significant correlation between radiation parameters and PFT abnormalities was noted.
authors.affiliation: Division of Pulmonology, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Aliva
authors.initials: A
authors.lastname: De
authors.affiliation: Division of Pulmonology, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kamath
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Radiation Oncology, University of California, Los Angeles, California.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Radiation Oncology, University of Southern California, Los Angeles, California.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Olch
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Jemily
authors.initials: J
authors.lastname: Malvar
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Sposto
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Leo
authors.initials: L
authors.lastname: Mascarenhas
authors.affiliation: Division of Pulmonology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Keens
authors.affiliation: Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California.|Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Venkatramani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000503:physiopathology / Q000528:radiation effects*; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009369:Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult
keywords: childhood cancer; dose volume histogram; lung radiation; pulmonary function abnormalities; pulmonary toxicity; radiation therapy