title: Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy.
abstract: OBJECTIVE
  Using prospectively collected patient-related, dose-related, and pulmonary function test (PFT) data before radiotherapy (RT) and at several follow-up visits after RT, the time course of PFT changes after high-dose radio(chemo)therapy and influencing factors were analyzed.
  
  
  METHODS
  From April 2012 to October 2015, 81 patients with non-small-cell lung carcinoma (NSCLC), small cell lung carcinoma (SCLC), or esophageal carcinoma where treated with high-dose radio(chemo)therapy. PFT data were collected before treatment and 6 weeks, 12 weeks, and 6 months after RT. The influence of patient- and treatment-related factors on PFT was analyzed.
  
  
  RESULTS
  Mean forced expiratory volume in 1 s (FEV1) constantly declined during follow-up (p = 0.001). In total, 68% of patients had a reduced FEV1 at 6 months. Mean vital capacity (VC) didn't change during follow-up (p > 0.05). Mean total lung capacity (TLC) showed a constant decline after RT (p = 0.026). At 6 months, 60% of patients showed a decline in VC and 73% in TLC. The mean diffusion capacity for carbon monoxide (DLCO) declined at 6 and 12 weeks, but recovered slightly at 6 months (p < 0.0005). At 6 months, 86% of patients had a reduced DLCO. After treatment, the partial pressure of CO2in the blood (pCO2) was increased and pO2was decreased (p > 0.05). Only the pretreatment PFT classification had a significant influence on the post-RT FEV1.
  
  
  CONCLUSIONS
  DLCO seems to be the most reliable indicator for lung tissue damage after thoracic RT. Ventilation parameters appear to be less reliable. Concerning patient- or treatment-related factors, no reliable conclusion can be drawn regarding which factors may be relevant.
authors: Clinic for Radiotherapy and Radiation Oncology, University Clinic Giessen and Marburg, Marburg, Germany. christina.schroeder@med.uni-giessen.de.|Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany. christina.schroeder@med.uni-giessen.de.
authors: Christina
authors: C
authors: Schröder
authors: Clinic for Radiotherapy and Radiation Oncology, University Clinic Giessen and Marburg, Marburg, Germany.
authors: Rita
authors: R
authors: Engenhart-Cabillic
authors: Clinic for Radiotherapy and Radiation Oncology, University Clinic Giessen and Marburg, Marburg, Germany.
authors: Hilke
authors: H
authors: Vorwerk
authors: Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany.
authors: Michael
authors: M
authors: Schmidt
authors: Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany.
authors: Winfried
authors: W
authors: Huhnt
authors: Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany.
authors: Eyck
authors: E
authors: Blank
authors: Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany.
authors: Dietrich
authors: D
authors: Sidow
authors: Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany.
authors: André
authors: A
authors: Buchali
mesh_terms: D000368:Aged; D015984:Causality; D059248:Chemoradiotherapy / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D055370:Lung Injury / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology*; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D012307:Risk Factors; D013899:Thoracic Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Carcinoma, non-small-cell lung; Intensity-modulated radiotherapy; Lung; Radiation injuries; Respiratory function tests