Longitudinal Evaluation of Lung Function in Patients With Advanced Non-Small Cell Lung Cancer Treated With Concurrent Chemoradiation Therapy.
Int J Radiat Oncol Biol Phys
; 101(4): 910-918, 2018 07 15.
Article
in En
| MEDLINE
| ID: mdl-29976503
ABSTRACT
PURPOSE:
In lung cancer patients, radiation therapy modifies lung architecture, resulting in functional deterioration, which worsens symptoms and reduces quality of life. METHODS AND MATERIALS A multicenter, prospective, longitudinal study was conducted in a cohort of patients with locally advanced and oligometastatic non-small cell lung cancer treated with concurrent chemoradiation therapy (CCRT). A wide array of pulmonary function tests (forced spirometry, body plethysmography, impulse oscillometry, carbon monoxide diffusing capacity, fraction of exhaled nitric oxide, arterial blood gases, and 6-minute walk test) were used to evaluate lung function at baseline; after radiation therapy; and at 6, 12, 24, and 48 weeks after CCRT. Relative changes in test results (percentages) were estimated at the aforementioned intervals and compared with baseline results.RESULTS:
Thirty-seven patients completed the follow-up and were included in the analysis. After CCRT, patients showed a maximum decline in lung volumes as follows (1) 31% in forced expiratory volume in the first second after 24 weeks (P = .008), (2) 9.6% in forced vital capacity after 48 weeks (P = .04), and (3) 15.1% in total lung capacity after 48 weeks (P = .0015). Similarly, at 12 weeks after CCRT, patients showed a 21.8% decrease in carbon monoxide diffusing capacity (P = .002). Increases were found in total airway resistance (respiratory system resistance at 5 Hz), frequency dependence of resistance (change in respiratory system resistance at 5 Hz-respiratory system resistance at 20 Hz, P = .012), and reactance (P = .0003 for respiratory system reactance at 5 Hz and P = .001 for reactance area), which together indicate small-airway dysfunction.CONCLUSIONS:
The longitudinal evaluation of lung function through pulmonary function tests detects CCRT-induced damage before the appearance of clinical symptoms associated with CCRT lung toxicity.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Non-Small-Cell Lung
/
Chemoradiotherapy
/
Lung
/
Lung Neoplasms
Type of study:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Int J Radiat Oncol Biol Phys
Year:
2018
Document type:
Article