Am. J. Respir. Crit. Care Med., Vol 152, No. 6, 12 1995, 2044-2048.
Pulmonary function changes in lung-cancer patients treated with radiation with or without carboplatin
HJ Groen, TW van der Mark, AH van der Leest, EG de Vries and NH Mulder
Department of Pulmonary Diseases, University Hospital Groningen, The Netherlands.
In order to examine changes in pulmonary function in patients with locally
advanced non-small-cell lung cancer (NSCLC) before, during, and after
standard radiotherapy or combined chemoradiotherapy, we conducted a
prospective study involving patients with such cancer, who were treated
with radiation alone or with concurrent radiation and carboplatin from
October 1992 to February 1994 at the University Hospital in Groningen, the
Netherlands. Thirty-five patients were treated. Two patients were excluded
because of pulmonary emphysema. Pretreatment values of TLC, VC, the
gas-transfer coefficient (Kco), the pulmonary diffusing membrane factor
(Dm), and pulmonary capillary blood volume (Vcap) were lower than in normal
subjects and patients with chemotherapy-naive germ-cell carcinoma who had a
similar pulmonary tumor load as the result of hematogenous metastases. The
NSCLC patients' reduced Kco was explained by a decrease in Dm, a measure of
alveolar-capillary membrane disturbance, and a similar decrease in Vcap.
Pretreatment TLC did not correlate with Vcap or Dm, indicating extra-
rather than intrapulmonary vascular and lymphatic obstruction as an
explanation for the reduced Vcap and Dm. Locally advanced NSCLC was treated
with radiation (n = 16) or combined continuous carboplatin infusion and
radiation (n = 17). No changes in TLC, VC, Kco, Dm, or Vcap were observed
during and 2 wk after the end of either treatment, nor were any differences
in pulmonary function observed with the two treatments, indicating an
absence of additional acute pulmonary toxicity caused by continuously
infused carboplatin in this patient group.(ABSTRACT TRUNCATED AT 250 WORDS)
