Toxic influence of current therapy of lymphogranulomatosis on pulmonary respiration and gas transport function of blood in patients in long-term remission.

78 patients received mediastinal radiotherapy (RT) in total dose 35-50 Gy. Ten patients were assigned to RT alone; 47 patients to chemotherapy (CT) wi th COPP and RT; 11 patients to CT with MOPP and RT; 10 patients to CT both with MOPP and COPP and RT. The frewunecy of pulmonary fibrosis in the total dose 35-42 Gy reached 29.7%. But it raised almost twice (58.5%) in the inc rease of the total dose up to 44-50 Gy. The relative number of cases of mod erate and severe fibrosis rose 5.5-fold, from 9 up to 50%. Pulmonary functi on test made in 55 patients. Disorders in pulmonary ventilation were found in 12.6% of the patients (restrictive - 5.4%, obstructive - 3.6%, mixed - 3 .6%). Low diffuse capacity of the lung was found in 20% of the patients, Th ere was a correlation between fibrosis severity and changes in the external respiration function. Combined chemoradiotherapy vs radiotherapy alone agg ravates disorders of lung ventilation by the restrictive type. This was not noted in MOPP and/or COPP treatment prolongation from 4 to 11 courses in c ombined treatment of Hodgkin's disease. Total hemoglobin, oxygen and its pa rtial pressure were moderately low. MOderate respiratory acidosis was found in 19, metabolic acidosis in 1.5% of the patients. Effort dyspnea occurred in 25.6% of the patients. Conclusion. Organic and functional pulmonary dis orders occurred in 50-60% of the patients living more than 5 years after tr eatment for Hodgkin's disease. As to development of pulmonary complications it is safer to raise the quantity of MOPP and/or COPP courses than to incr ease total dose of mediastinal radiotherapy above 45 Gy.