Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Pediatric Hemato-Oncology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Pediatr Pulmonol. 2020 Dec;55(12):3450-3456. doi: 10.1002/ppul.25071. Epub 2020 Sep 24.
Childhood cancer survivors (CSs) might face an increased lifelong risk of lung function impairment. The lung clearance index (LCI) has been described as being more sensitive than spirometry in the early stages of some lung diseases. The aim of this study was to evaluate this index in a cohort of patients with a history of childhood cancer for the first time.
We evaluated 57 off-treatment CSs aged 0-18 years old and 50 healthy controls (HCs). We used the multiple-breath washout method to study LCI and spirometry.
CSs did not show any differences from the controls in ventilation homogeneity (LCI 6.78 ± 1.35 vs. 6.32 ± 0.44; p: not significant [ns]) or lung function (FEV1 99.9 ± 11.3% vs. 103.0 ± 5.9% of predicted; p: ns; FVC 98.2 ± 10.3% vs. 101.1 ± 3.3% of predicted). LCI significantly correlated with the number of years since the last chemotherapy (r = .35, p < .05).
Our study describes the trend of LCI in a cohort of CSs and compares it with the results obtained from HCs. The results show that patients maintain both good values of respiratory function and good homogeneity of ventilation during childhood. Moreover, as LCI increases and worsens as the years pass after the end of the treatment could identify the tendency toward pulmonary fibrosis, which is typical of adult CSs, at an earlier time than spirometry.
儿童癌症幸存者（CSs）可能面临终生肺功能受损风险增加。肺清除指数（LCI）在某些肺部疾病的早期阶段比肺活量计更敏感。本研究的目的是首次评估该指数在一组有儿童癌症病史的患者中的应用。
我们评估了 57 名接受治疗的 0-18 岁 CS 患者和 50 名健康对照者（HCs）。我们使用多次呼吸冲洗法研究 LCI 和肺活量计。
CS 与对照组在通气均一性方面无差异（LCI 6.78±1.35 与 6.32±0.44；p：无统计学意义[ns]）或肺功能（FEV1 99.9±11.3%与 103.0±5.9%预测值；p：ns；FVC 98.2±10.3%与 101.1±3.3%预测值）。LCI 与末次化疗后时间显著相关（r=0.35，p<0.05）。
本研究描述了一组 CSs 中 LCI 的趋势，并将其与 HCs 的结果进行了比较。结果表明，患者在儿童时期保持良好的呼吸功能和良好的通气均一性。此外，LCI 在治疗结束后随着时间的推移而增加和恶化，可能比肺活量计更早地识别出成人 CSs 特有的肺纤维化趋势。
