Effect of radiotherapy and chemotherapy on pulmonary function after treatment for breast cancer and lymphoma: A follow-up study

Purpose: To determine the changes in pulmonary function tests (PFTs) 0 to 4 8 months after treatment for breast cancer and lymphoma. Patients and Methods: The alveolar volume (VA)I vital capacity, forced expi ratory volume in I second, and corrected transfer factor of carbon monoxide (T-L,T-COc) were measured in 69 breast cancer and 41 lymphoma patients bef ore treatment and 3, 18, and 48 months after treatment with radiotherapy al one or radiotherapy in combination with chemotherapy (mechlorethamine, vinc ristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine; cyc lophosphamide, epidoxarubicin, fluorouracil; cyclophosphamide, thiotepa, ca rboplatin; cyclophosphamide, methotrexate, fluorouracil). The three-dimensi onal dose distribution in the lung of each patient was converted to the mea n lung dose. Statistical analysis was used to evaluate the changes in PFT v alues over time in relation to age, sex, smoking, chemotherapy, and the mea n lung dose. Results: After an initial reduction in PFT values at 3 months, significant recovery was seen at 18 months for all patients. Thereafter, no further imp rovement could be demonstrated. Reductions in spirometry values and Vn were related to the mean lung dose only (0.9% per Gy at 3 months and 0.4% per G y mean dose at 18 months), T-L,T-COc decreased 1.1% per Gy mean dose and ad ditionally decreased 6% when chemotherapy was given after radiotherapy. Che motherapy administered before radiotherapy reduced baseline T-L,T-COc value s by 8% to 21%. All patients showed an improvement of 5% at 18 months. Conclusion: On the basis of the mean lung dose and the chemotherapy regimen , the changes in PFT values can be estimated before treatment within 10% of the values actually observed in 72% to 85% of our patients with healthy lu ngs. (C) 1999 by American Society of Clinical Oncology.