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Pulmonary function abnormalities in children treated with whole lung irradiation
Daniel J Weiner1, Amit Maity, Claire A Carlson
1Department of Pediatrics, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA. weiner@email.chop.edu
Pediatric Blood & Cancer
|June 1, 2005
Summary
Pulmonary function abnormalities are common in children treated with whole lung irradiation (WLI). These lung function test (LFT) changes, including reduced FEV1 and TLC, may worsen over time.
Area of Science:
- Pediatric Oncology
- Pulmonary Medicine
- Radiation Oncology
Background:
- Whole lung irradiation (WLI) is used to treat metastatic disease in children.
- The long-term pulmonary effects of WLI in pediatric patients are not fully understood.
Purpose of the Study:
- To determine the prevalence of abnormal pulmonary function tests (PFTs) in children treated with WLI.
- To assess the impact of WLI on lung function in a pediatric cohort.
Main Methods:
- Retrospective chart review of pediatric patients treated with WLI between 1988-2003.
- Analysis of spirometry, plethysmography, diffusing capacity, and respiratory muscle strength.
- Pulmonary function tests (PFTs) were normalized using standard deviation (Z) scores.
Main Results:
- 50% of patients had normal FEV1, while 50% showed reductions (30% mild, 10% moderate, 10% severe).
- Reductions in total lung capacity (TLC) were observed in 17% (mild), 13% (moderate), and 30% (severe).
- Diffusing capacity abnormalities were present in 38% (mild), 29% (moderate), and 14% (severe).
Conclusions:
- Abnormal pulmonary function is common in children treated with WLI.
- These pulmonary function abnormalities may be progressive.
- Further research is needed to identify children at higher risk for PFT changes.