ASSESSMENT OF CHANGES IN PULMONARY FUNCTION AFTER RADIATION IN LUNG CANCER PATIENTS – A PROSPECTIVE OBSERVATIONAL STUDY

Dr. Sunita Das, Dr. Tapas Kumar Das

Abstract


Background: Randomized trials have found that treatment with chemotherapy & radiotherapy led to improved survival for inoperable locally
advanced non small cell lung cancer patients (NSCLC). Sufficient data is not available in our developing country regarding changes on pulmonary
function after radiotherapy in lung cancer. Despite newer technical developments of radiation therapy in treatment of NSCLC, radiation-induced
lung toxicity (RILT) remains a crucial problem. Clinically assessed RILT scores have their limitations, and more objective measures such as
pulmonary functions tests (PFTs) might help to improve treatment protocol.
Objectives: Assessment of pulmonary function with respect to FEV1, FVC, FEV1/FVC, PEFR, FEF25 – 75%.
Material & Methods : All biopsy proven 62 cases of Non small cell carcinoma of lung (NSCLC) were included. All patients received post
chemotherapy conventional external radiation 60 Gy in 30 fractions for 6 weeks by Teletherapy Theratron 780e Cobalt60 machines. After
clinical assessment, all patients were placed for Pulmonary function tests ( FEV1, FVC, FEV1/FVC, PEFR, FEF25 – 75%) at baseline, 1 month,
3 month after completion of radiation. Spirometric analysis was done by electronic spirometer ( HELIOS 702 ). Data analysis was done by SPSS
software.
Results: 62 patients were included in this study. All lung function parameter did not shows significant changes after radiation, compared to baseline
study. All p value show >0.05.
Conclusion: In my study, no statistically significant changes are found in the lung function parameters.


Keywords


External radiation, lung function, spirometric analysis

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References


American Cancer society: Key statistics of Lung Cancer, last medical review on 9th February, 2016.

Klaus Flenchel et al. Overall survival in non-small cell lung cancer—what is clinically meaningful?Transl Lung Cancer Res. 2016 Feb; 5(1): 115–119

Murry W. Wynes et al, Increased overall survival for advanced stage nsclc patients is associated with availability of less toxic chemotherapy, International Association for study of Lung Cancer 2014, (720) 325-2945

NSCLC Meta-Analysis Collaborative Group. J Clin Oncol. 2008;26:4617-4625

Salah Abbasi and Ahmed Badheeb et al. Prognostic Factors in Advanced Non-Small-Cell Lung Cancer Patients: Patient Characteristics and Type of Chemotherapy, Lung Cancer International, Volume 2011, Article ID 152125, 4 pages.

ShengFaSu et al. The survival outcomes and prognosis of stage IV non-small-cell lung cancer treated with thoracic three-dimensional radiotherapy combined with chemotherapy, RadiatOncol. 2014; 9: 290

Kelly K, et al. J Clin Oncol. 2001;19:3210-3218, Efficacy of CT in First Line Treatment of Advanced NSCLC.

Cerfolio RJ, Talati A, Bryant AS. Changes in pulmonary function tests after neoadjuvant therapy predict postoperative complications. Ann Thorac Surg. 2009;88:930–935. discussion 935-936.

Semrau S, Klautke G, Fietkau R. Baseline cardiopulmonary function as an independent prognostic factor for survival of inoperable non-small-cell lung cancer after concurrent chemoradiotherapy: a single-center analysis of 161 cases. Int J Radiat Oncol Biol Phys. 2011;79:96–104.

Varsha Jain* and Abigail T. Berman. Radiation Pneumonitis: Old Problem, New Tricks: Cancers (Basel). 2018 Jul; 10(7): 222.

Margaritora, A. Cesario, G. Cusumano, S. Cafarotti, G.M. Corbo, L. Ferri, et al. Is pulmonary function damaged by neoadjuvant lung cancer therapy? A comprehensive serial time-trend analysis of pulmonary function after induction radiochemotherapy plus surgery, In The Journal of Thoracic and Cardiovascular Surgery, 2010; 139(6); 1457-1463.

Guerra JL Lopez, Gomez R David, et al. Changes in Pulmonary Function after Three Dimensional Conformal Radiation Therapy, Intensity Modulated Therapy, or Proton Beam Therapyfor Non Small Cell Lung Cancer. IJROBP 2012;83(4):e537-e543.

Gopal R, Starkschall G, Tucker SL, Cox JD, Liao Z, et al.Effects of radiotherapy and chemotherapy on lung function in patients with non-small-cell lung cancer. IJROBP 2003:56(1);114-20.

Miller KL, Zhou SM, Barrier RC, Jr, et al. Long-term changes in pulmonary function tests after definitive radiotherapy for lung cancer. Int J Radiat Oncol Biol Phys. 2003;56:611–615.

Borst GR, Ishikawa M, Nijkamp J, Hauptmann M, Shirato H, Onimaru R, et al. Radiation pneumonitis in patients treated for malignant pulmonary lesions with hypofractionated radiation therapy. Radiother Oncol 2009;91:307-13.

Pulmonary Function Changes After Radiotherapy for Lung or Esophageal Cancer: A Systematic Review Focusing on Dose‐Volume Parameters, Anne G.H. Niezink et al. a Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Perez CA, Stanley K, Grundy G, et al. Impact of irradiation technique and tumor extent in tumor control and survival of patients with unresectable non-oat cell carcinoma of the lung: report by the Radiation Therapy Oncology Group. Cancer. 1982;50:1091–1099.

Claude L, Perol D, Ginestet C, et al. A prospective study on radiation pneumonitis following conformal radiation therapy in non-small-cell lung cancer: clinical and dosimetric factors analysis. Radiother Oncol. 2004;71:175–181.

Shi A, Zhu G, Wu H, Yu R, Li F, Xu B. Analysis of clinical and dosimetric factors associated with severe acute radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent chemotherapy and intensity-modulated radiotherapy. Radiat Oncol. 2010;5:35.

Robnett TJ, Machtay M, Vines EF, McKenna MG, Algazy KM, McKenna WG. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2000;48:89–94.


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