Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Bakırçay University, Izmir, Turkey.
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Trakya University, Edirne, Turkey.
BMC Pulm Med. 2024 Feb 14;24(1):83. doi: 10.1186/s12890-024-02890-5.
Respiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients' clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer.
A total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1).
25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks' lambda, F [1, 19] = 6.561, p =.019, ηp = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, ηp = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037).
The present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy.
乳腺癌（BC）患者在化疗（CT）和放疗（RT）后出现的呼吸系统并发症已得到充分认识，应进行这些并发症的调查，以预防继发性问题和/或改善 BC 患者的临床结局。因此，本研究旨在评估全身化疗和放疗对乳腺癌患者呼吸功能和功能状态的潜在急性影响。
对 25 名接受全身化疗和放疗的 BC 患者进行了肿瘤学检查，并在这项研究中入选。通过肺功能测试（PFT）和 6 分钟步行测试（6MWT）分别评估呼吸功能和功能状态。患者在 CT 前（c0）、CT 后（c1）和 RT 后（r1）进行评估。
25 名 BC 患者在 c0 和 c1 时进行了评估，而只有 25 名患者中的 15 名（60%）在 r1 时进行了评估。用力肺活量（FVC）的实际值（t=2.338，p=0.028）、1 秒用力呼气量（FEV1）（t=2.708，p=0.012）和用力呼气量在 25%至 75%肺活量之间的比值（FEF25-75%）（t=2.200，p=0.038）在全身 CT 后差异有统计学意义。吸气（MIP）和呼气（MEP）肌肉力量也没有显示从 c0 到 c1 的显著变化。在 c0 和 c1 之间，FVC 的实际值存在手术类型的显著影响（Wilks lambda，F[1,19]=6.561，p=0.019，ηp=0.25）。从 c0 到 r1，FVC 的主要效应时间具有统计学意义（F[2,28]=4.840，p=0.016，ηp=0.25）。进行 Bonferroni 校正后的成对比较显示，c0 和 r1 之间存在显著差异（p=0.037）。
本研究显示，从基线到治疗完成时，FVC 和 FEV1 的实际值和百分比预测值下降。由于手术类型的交互作用有统计学意义，因此我们建议，在解释 PFT 的早期变化时，应考虑临床和人口统计学因素，如年龄。此外，一些特定的呼吸功能指标呈显著线性下降趋势，这也突出表明需要从基线到化疗和放疗完成，对 BC 患者的潜在呼吸问题进行持续监测。
