在儿童癌症幸存者中对肺功能障碍的模式和风险因素进行病例对照分析:来自中低收入环境的单一中心研究
Payal Malhotra1, Sandeep Jain1, Rahul Sharma1
1Department of Pediatric Hematology-Oncology and Bone Marrow Transplant, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Pediatric hematology and oncology
|February 8, 2025
概括
肺部毒性在儿童癌症幸存者 (CCS) 中很常见. 超过一半的CCS显示肺功能测试异常,胸部放射治疗和更长的随访是肺损伤的关键风险因素.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 儿科医学 儿科医学
背景情况:
- 肺毒性是儿童癌症幸存者 (CCS) 的一个重要的长期并发症.
- 了解肺功能障碍的患病率,模式和风险因素对于管理CCS至关重要.
- 早期识别和干预可以减轻长期的呼吸道发病率.
研究的目的:
- 确定肺功能障碍在CCS中的患病率和模式.
- 确定与CCS肺部异常相关的风险因素.
- 为了比较CCS和年龄/性别匹配的对照组之间的肺功能.
主要方法:
- 在192个CCS和50个对照中对人口统计数据,肺毒性治疗史和肺功能测试 (PFT) 的横截面分析.
- PFT包括螺旋测量 (分类为正常,限制性或阻塞性) 和一氧化碳 (DLCO) 的扩散能力.
- 用单变量和多变量逻辑回归分析了风险因素.
主要成果:
- 在58.3%的CCS中发现异常的PFT (精神测量或DLCO),而对照组为16% (p<0.01).
- 最常见的异常是减少DLCO (44%),其次是阻塞性 (34.3%) 和限制性 (21.8%) 模式.
- 评估时的年龄较大,随访时间较长,胸部导向放射治疗和累积白色素剂量是异常PFT的显著预测因素.
结论:
- 儿童癌症幸存者表现出亚临床肺功能障碍的高患病率.
- 胸部导向放射治疗和更长的随访时间是CCS肺损伤的重要风险因素.
- 长期跟踪和有针对性的干预措施是必要的,以管理CCS的长期肺结局.
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