title: Pilot Feasibility Study of Comprehensive Pulmonary Evaluation Following Lung Radiation Therapy.
abstract: BACKGROUND
  Symptoms of pulmonary injury following lung irradiation may not manifest clinically in childhood. We performed comprehensive pulmonary evaluation of patients who had received lung irradiation for treatment of cancer.
  
  
  METHODS
  Patients underwent a focused history and physical examination, computed tomography of the chest, pulmonary function test, and cardiopulmonary exercise stress test (CPET). Health-related Quality of Life was also measured.
  
  
  RESULTS
  Fourteen patients were recruited with median age of 16 years (range, 6 to 21 y). Median time from pulmonary radiation to testing was 5 years (range, 2 to 11 y). Five patients reported pulmonary symptoms. Twelve patients (85.7%) had at least 1 pulmonary function test abnormality. Nine patients demonstrated CPET abnormalities; 7 patients had abnormal pulmonary limitation to exercise, and 5 patients had exercise-induced bronchospasm. The pulmonary limitations included abnormal ventilatory response to exercise in 5 patients, and gas exchange abnormalities in 4 patients. Chest computed tomography demonstrated grade 1-2 radiation-induced lung changes in 4 patients, and grade 3 abnormalities in 1 patient.
  
  
  CONCLUSIONS
  Significant pulmonary dysfunction was observed in childhood cancer survivors who had received lung irradiation. CPET is feasible in childhood cancer survivors and can be valuable for assessment of pulmonary function and exercise capacity.
authors.affiliation: *Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY Divisions of †Pulmonology ‡Hematology, Oncology and BMT, Children's Hospital Los Angeles §Department of Pediatrics, Keck School of Medicine ∥Department of Radiology, University of Southern California, Los Angeles, CA ¶Baylor College of Medicine, Texas Children's Cancer and Hematology Centers, Houston, TX.
authors.forename: Aliva
authors.initials: A
authors.lastname: De
authors.forename: Leo
authors.initials: L
authors.lastname: Mascarenhas
authors.forename: Sunil
authors.initials: S
authors.lastname: Kamath
authors.forename: Alejandro
authors.initials: A
authors.lastname: LaRiviere
authors.forename: Fariba
authors.initials: F
authors.lastname: Goodarzian
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Keens
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Venkatramani
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D010865:Pilot Projects; D011832:Radiation Injuries / Q000175:diagnosis*; D011878:Radiotherapy / Q000009:adverse effects*; D017741:Survivors; D055815:Young Adult