Impact of Respiratory Developmental Stage on Sensitivity to Late Effects of Radiation in Pediatric Cancer Survivors

Advances in Radiation Oncology
Fatima KhanLouis S Constine

Abstract

Pulmonary dysfunction is a prevalent and potentially debilitating late effect of pediatric cancer treatment. We postulated that age, as a surrogate for respiratory developmental status, might be associated with vulnerability to pulmonary injury. Sixty-one children treated with lung radiation at our institution who had undergone a pulmonary function test (PFT) between 1995 and 2016 were analyzed. Data collection included age at diagnosis and treatment, radiation dose and location, spirometry, and plethysmography results. PFTs were normalized according to age, sex, height, and ethnicity, and transformed into standardized z-scores. Obstructive disease was defined as forced expiratory volume in 1 second z score/forced vital capacity z score < -1.645, restrictive as total lung capacity z score < -1.645, and abnormal diffusion as diffusing capacity of the lung for carbon monoxide z score < -1.645. We determined the incidence of PFT abnormalities in our population and estimated the relative risk of developing pulmonary abnormalities using models adjusted for age. At a mean age of 24 years (range, 12-31) and time from radiation of 9 years (range, 1-20), the cumulative incidence of any pulmonary abnormality was 34.4%. Among patients wit...Continue Reading

Citations

Mar 16, 2021·Critical Reviews in Oncology/hematology·Simon HoVictoria Marchese

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