AIM: To evaluate pulmonary function in childhood cancer survivors (CCS) compared to age and sex-matched controls.
METHODS: In this multicenter European cross-sectional study (Norway, Switzerland), 157 CCS and 113 controls (age range 9-18 years) performed spirometry and whole-body plethysmography, and measured lung diffusion capacity, according to guidelines. Multi-level linear statistical models were used to compare CCS and controls. Predicted values were according to Global Lung Initiative.
RESULTS: Mean age was 13.4±2.6 years. The most common cancer diagnoses were leukemia (50%), brain tumors (11%) and lymphoma (10%). The majority (78%) of CCS had received chemotherapy with anthracyclines. Tabulated preliminary data showing differences between CCS and controls (95% CI):
| CCS | Controls |
Difference (p-value) |
|
| FVC, liter | 3.23 (3.10-3.36) | 3.48 (3.34-3.62) | 0.25 (0.006) |
| FVC % pred | 98 (95-101) | 102 (99-105) | 4 (0.052) |
| FEV1, liter/sec | 2.73 (2.55-2.91) | 2.93 (2.74-3.12) | 0.20 (0.011) |
| FEV1 % pred | 95 (91-99) | 99 (95-103) | 4 (0.075) |
| MVV, liter/min | 108 (104-113) | 117 (112-122) | 9 (0.006) |
| TLC, liter | 4.27 (4.12-4.43) | 4.66 (4.46-4.86) | 0.39 (0.002) |
| TLC % pred | 99 (96-102) | 103 (100-106) | 4 (0.030) |
| RV, liter | 0.99 (0.92-1.05) | 1.08 (1.00-1.16) | 0.09 (0.059) |
| RV % pred | 101 (94-108) | 105 (97-114) | 4 (0.432) |
| DLCO, mmol/min/kPa | 7.3 (7.1-7.6) | 7.9 (7.5-8.3) | 0.6 (0.013) |
| DLCO % pred | 101 (98-104) | 106 (101-110) | 5 (0.074) |
| KCO, mmol/min/kPa/liter | 1.79 (1.75-1.83) | 1.79 (1.74-1.85) | 0 (0.982) |
| KCO % pred | 103 (100-105) | 103 (100-106) | 1 (0.685) |
CONCLUSION: Pulmonary function was well preserved in CCS despite significant differences between CCS and controls. There was no evidence of diffusion limitation induced by treatment toxicity.