Lung function following treatment of malignant tumors with surgery, radiotherapy, or cyclophosphamide in childhood. A follow-up study after 11 to 27 years

A group of 40 individuals were restudied at a median follow-up time of 18 years after chest surgery, chest irradiation, or cyclophosphamide treatment. Their median age at diagnosis was 4.5 years. Nineteen subjects were operated on in the chest area. Radiotherapy of the chest had been used in 21 and cyclophosphamide in 35 patients. Chest deformity was evident in 17 subjects. Chest radiographs showed some evidence of fibrosis in eight subjects and late effects of surgery in three subjects. In nine subjects some evidence of fixed obstruction was seen in spirometry. In three subjects pulmonary diffusion capacity was abnormal. Spirometry commonly showed a restrictive pattern of findings. The incidence of abnormalities in pulmonary function was highest among the patients diagnosed before age 3 years. Spirometry was more likely to reveal abnormalities in patients who had received irradiation to the chest. However, abnormalities in pulmonary function were fewer than anticipated.