Lehne G, Johansen B, Fosså S D
Department of Medical Oncology and Radiotherapy, Norwegian Radium Hospital, Montebello, Oslo.
Br J Cancer. 1993 Sep;68(3):555-8. doi: 10.1038/bjc.1993.385.
A follow-up study of pulmonary function in two groups of patients with testicular cancer was performed 6-12 years after treatment. Both groups, 47 patients in each, had undergone retroperitoneal lymph node dissection (RPLND). Patients with pathological stage (ps) II had also received bleomycin (median 270 mg) and cisplatin (median 540 mg) in three or four courses which included vinblastine or etoposide. Patients in ps I and II were similar with respect to age, general health, observation period, inspired oxygen fraction (FiO2) and maximal arterial oxygen pressure (pO2) at RPLND, but four (8.2%) with psII disease developed densities on chest X-ray during chemotherapy. At the long-term follow-up the groups were similar with respect to physical exercise, smoking pattern, present drug treatment and history of cardiopulmonary disease. In both groups forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and single breath transfer factor for carbon monoxide (TLCO) were within normal limits, and no difference was found between the groups. The combined data for both groups showed that smoking was highly associated with impairment in TLCO (P = 0.005), and smoking frequency was negatively correlated to TLCO (P = 0.002). We conclude that 3-4 courses with bleomycin, cisplatin and etoposide/vinblastine in testicular cancer patients do not lead to long-term impairment of pulmonary function.
对两组睾丸癌患者在治疗后6至12年进行了肺功能随访研究。两组各有47例患者，均接受了腹膜后淋巴结清扫术（RPLND）。病理分期（ps）为II期的患者还接受了三到四个疗程的博来霉素（中位剂量270 mg）和顺铂（中位剂量540 mg）治疗，这些疗程包括长春花碱或依托泊苷。ps I期和II期患者在年龄、总体健康状况、观察期、RPLND时的吸入氧分数（FiO2）和最大动脉血氧分压（pO2）方面相似，但4例（8.2%）psII期疾病患者在化疗期间胸部X光片上出现了密度影。在长期随访中，两组在体育锻炼、吸烟模式、当前药物治疗和心肺疾病史方面相似。两组的用力肺活量（FVC）、一秒用力呼气量（FEV1）和一氧化碳单次呼吸转移因子（TLCO）均在正常范围内，两组之间未发现差异。两组的综合数据显示，吸烟与TLCO受损高度相关（P = 0.005），吸烟频率与TLCO呈负相关（P = 0.002）。我们得出结论，睾丸癌患者接受三到四个疗程的博来霉素、顺铂和依托泊苷/长春花碱治疗不会导致肺功能的长期损害。
