Lung function after mantle field irradiation in Hodgkin's disease

Seventeen patents with extrathoracic Hodgkin's disease were treated with mantle field ir radiation and repeatedly observed with regard to their ventilatory function for 9-23 months after the completion of radiotherapy. Twelve of them also underwent thorough studies of pulmonary gas exchange. The vital capacity was reduced on the average by about 10% shortly after the treatment. A corresponding reduction of the total lung capacity persisted and, at the end of the study, was partly due to a decrease of the residual volume as well. The irradiation had no apparent influence on the pulmonary gas exchange as judged from arterial blood gas tensions, alveolar-arterial oxygen difference, and dead space for CO2, determined at rest and during moderate exercise. The low level of restrictive ventilatory impairment and the absence of gas exchange disturbances are ascribed to effective shielding of the pulmonary parenchyma, leaving but marginal lung regions and extrapulmonary thoracic structures exposed to irradiation.