CHEMOTHERAPY-INDUCED AND RADIOTHERAPY-INDUCED CYTOLOGIC ALTERATIONS IN THE SPUTUM OF PATIENTS WITH INOPERABLE LUNG-CARCINOMA - ROLE IN FOLLOW-UP

OBJECTIVE: To define the light microscopic cytologic changes due to ch emotherapy (CT) and/or radiotherapy (RT); to evaluate the differentiat ion of those changes according to treatment; to find out whether a rel ation exists between treatment type and its duration and the cytologic findings; and to determine the role of sputum cytology in evaluating efficacy of treatment and follow-up in patients with inoperable lung c ancer of various histology. STUDY DESIGN: A total of 1,605 periodic sp utum samples from 80 cases of lung cancer obtained during treatment an d follow-up were prospectively examined cytologically. The relationshi p of treatment type and duration to qualitative and semiquantitative d ata and the definability of the response to treatment as well as the r elationship of progression-free survival (PFS) and total survival (TS) rates with cytologic data were evaluated. RESULTS: The majority of th erapy-induced cellular changes were in the nucleus and were directly r elated to the duration of treatment. An increase in minimally affected tumor cells, tumor cells that lost their pathologic features and necr otic cell debris were good indicators of therapeutic efficacy. Cytolog ic changes did not reflect PFS and TS rates. CONCLUSION: Although ligh t microscopic cytologic changes cannot be attributed objectively to ei ther RT or CT, therapeutic efficacy is shown in follow-up sputum cytol ogy, which can be used in monitoring and planning additional therapy o r other therapeutic options in lung cancer patients.