Abstract
We studied the effects the therapeutic plumonary irradiation in early childhood on lung mechanics and CO diffusing capacity (DCO) in ten children aged 11 to 19 years. Before the age of 50 months they had received bilateral irradiation to the lungs for treatment of metastatic Wilm's tumor. Radiographic evidence of pleural thickening and/or interstitial fibrosis was minimal except in 3 patients with moderately severe changes. Thoraco-lumbar scoliosis was present, but minimal. Total lung capicity (TLC) was 78% (range 68–87%) and vital capacity (VC) 72% (range 64–85%) of predicted values. However, 4 patients who had repeated pulmonary irradiation or surgical resection had TLC and VC averaging 66 and 55% of predicted, respectively. In the whole group DCO was 65% of predicted (range 49–85%). DCO/observed TLC was normal, suggesting that the reduction of DCO was related to that of lung volume. Flow volume curves were used to measure maximal expiratory flow rates at 25% VC because at low lung volumes flow rates depend on resistance of peripheral airways and elastic recoil of the lung. All patients had normal flow rates in relation to body size. Elastic recoil of the lung, measured in 3 patients was high normal. These findings suggest that small airways are of normal size. It cannot be stated with certainty whether the diminished lung volumes are related to altered growth of lung parenchyma or to interstitial fibrosis.
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Wohl, M., Jaffe, N., Traggis, D. et al. Late effects of pulmonary radiotherapy in early childhood upon lung function. Pediatr Res 5, 427 (1971). https://doi.org/10.1203/00006450-197108000-00233
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DOI: https://doi.org/10.1203/00006450-197108000-00233