Hassink E A, Souren T S, Boersma L J, Peerboom P F, Melkert R, van Zandwijk N, Lebesque J V, Bruning P F
Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Amsterdam.
Eur J Cancer. 1993;29A(3):343-7. doi: 10.1016/0959-8049(93)90382-p.
Pulmonary function tests were performed in 78 patients who had been curatively treated for Hodgkin's disease with mantle field irradiation 10-18 years ago. Mean values of the total lung capacity (95.2%), vital capacity (VC) (95.9%), forced expiratory volume in 1 s (FEV1) (90.6%), and carbon monoxide diffusing capacity per unit alveolar volume (82.7%) showed significant deviations from the predicted normal values, standardised for age, sex, race and height. In a multiple regression analysis the normalised total dose of irradiation, the field of irradiation, and the interval since irradiation had independent negative effects on the test results. Patients reported more coughing, wheezing and dyspnoea on exertion in comparison with hospital-visitors. Their smoking habits and reported pulmonary disease were not different. It is concluded that small, but significant impairment of pulmonary function exists after a follow-up of 14 (2) years [mean (S.D.)]. The clinical impact of these findings seems, however, minimal. Further avoidance of pulmonary toxicity requires a careful quantitative study of the effects of the radiation dose and irradiated volume.
对78例10至18年前接受斗篷野照射根治性治疗霍奇金病的患者进行了肺功能测试。总肺容量（95.2%）、肺活量（VC）（95.9%）、第1秒用力呼气量（FEV1）（90.6%）以及每单位肺泡容积一氧化碳弥散量（82.7%）的平均值与根据年龄、性别、种族和身高标准化后的预测正常值存在显著偏差。在多元回归分析中，照射的归一化总剂量、照射野以及照射后的时间间隔对测试结果有独立的负面影响。与医院访客相比，患者报告在运动时咳嗽、喘息和呼吸困难更多。他们的吸烟习惯和报告的肺部疾病并无差异。得出结论，在随访14（2）年[平均（标准差）]后存在轻微但显著的肺功能损害。然而，这些发现的临床影响似乎极小。进一步避免肺部毒性需要对辐射剂量和照射体积的影响进行仔细的定量研究。
