LUNG-FUNCTION IMPAIRMENT IN LONG-TERM SURVIVORS OF HODGKINS-DISEASE

Background: Treatment of Hodgkin's disease (HD) involves radiation and chemotherapy, modalities known to cause lung injury. Patients and met hods: In Norway, between 1980 and 1988, 129 patients aged less than 50 years at the time of diagnosis, had curative treatment with thoracic radiation alone or combined-modality therapy for supradiaphragmatic HD . We have examined 116 (90%) of these patients by interview, chest X-r ay and lung function tests, 5-13 years after treatment. Results: Nearl y 30% of the patients had dyspnoea on exertion and associated reductio ns in total lung capacity (TLC), forced vital capacity (FVC), forced e xpiratory volume in 1 second (FEV1) and gas transfer (TLCO) (p<0.05). Radiographic evidence of no, slight or moderate fibrosis occurred in 3 2%, 54% and 14% of the patients, respectively Moderate fibrosis was as sociated with reductions in FVC, FEV1 and TLCO (p<0.05). Radiation plu s chemotherapy containing bleomycin-anthracyclines (median cumulative bleomycin dose 120 mg) was associated with decreases in FVC and TLCO ( p<0.05). Ln the multivariate analysis, chemotherapy with bleomycin-ant hracyclines was the only significant predictor for lung function impai rment. Conclusion: More than five years after therapy, respiratory sym ptoms and reduction in lung function were diagnosed in nearly one-thir d of otherwise healthy HD survivors.