Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy

Abstract

DLCO seems to be the most reliable indicator for lung tissue damage after thoracic RT. Ventilation parameters appear to be less reliable. Concerning patient- or treatment-related factors, no reliable conclusion can be drawn regarding which factors may be relevant.

Long-Term Survival after Salvage Surgery for Local Failure after Definitive Chemoradiation Therapy for Locally Advanced Non-small Cell Lung Cancer

“…Those changes can persist even 6 months after the high-dose RT. 9 The second-line chemotherapy can also be an alternative for the local failure. Systematic literature review demonstrates a minimal survival increase with a median long-term survival and progressive-free survival of 9 and 6 months, respectively, for several modern anticancer drugs.…”

Radiation-induced lung toxicity – cellular and molecular mechanisms of pathogenesis, management, and literature review

“…The benefit of lung function tests for determining the grade of RIP, such as spirometry with lung diffusion capacity test, remains unclear. Several studies investigated changes in lung function after thoracic radiotherapy, and the extent of change in diffusing capacity of lung for carbon monoxide (DLCO) upon radiotherapy of non-small cell lung cancer (NSCLC) patients was reported to be associated with the RIP grade [ 48 , 49 ]. However, no national or international consensus has yet been established.…”

Impact of Low-Dose Irradiation of the Lung and Heart on Toxicity and Pulmonary Function Parameters after Thoracic Radiotherapy

“…Pulmonary function tests are easy to assess and help to identify radiation-induced damage of lung tissue after RT [1][2][3][8][9][10]12,13,20,34,35]. In particular, diffusion parameters such as DL CO have proven to be reliable as they show the largest decline and least recovery after RT [1,2,[8][9][10][11][12][13][14][15][16][17][18][19].…”

“…Ventilation parameters such as vital capacity (VC) can both decrease or improve after treatment, presumably due to the re-opening of obstructed airways [1][2][3][4][5][6][7]. The diffusion, commonly measured using the diffusion capacity for carbon monoxide (DL CO ), however, has often been reported to decrease after RT [1,2,[8][9][10][11][12][13][14][15][16][17][18][19] and to show little to no recovery [5,12,20].…”