From Chest: Lung toxicity in childhood cancer survivors

http://www.ncbi.nlm.nih.gov/pubmed/21415131

Chest. 2011 Mar 17. [Epub ahead of print]
Pulmonary outcomes in survivors of childhood cancer: a systematic review.
Huang TT, Hudson MM, Stokes DC, Krasin MJ, Spunt SL, Ness KK.

Departments of Epidemiology and Cancer Control.
Abstract
AbstractBackground/Rationale: The purpose of this manuscript is to summarize the literature that documents the long-term impact of cancer treatment modalities on pulmonary function among survivors of cancer, and identify potential areas for further research.

METHODS: Systematic review of clinical trials, observational studies, case series, and review articles were conducted. Articles were limited to the studies that discussed pulmonary toxicity or late effects among pediatric cancer survivors, and to follow-up investigations that were conducted a minimum of two years after completion of cancer-related treatment or one year after hematopoietic stem cell transplant.

RESULTS: Sixty publications (51 clinical studies/reports and 9 reviews) published from January 1970 to June 2010 in PUBMED met the inclusion criteria. Data showed an association between radiotherapy, alkylating agents, bleomycin, hematopoietic stem cell transplant, and thoracic surgery and pulmonary toxicity as well as possible interactions among these modalities

CONCLUSIONS: Pulmonary toxicity is a common long-term complication of exposure to certain anticancer therapies in childhood, and can vary from sub-clinical to life-threatening. Pulmonary function and associated loss of optimal exercise capacity may have adverse effects on long-term quality of life in survivors. Lung function diminishes as a function of normal aging and the effects of early lung injury from cancer therapy may compound these changes. The information presented in this review is designed to provide a stimulus to promote both observational and interventional research that expands our knowledge and aids in design of interventions to prevent or ameliorate pulmonary late effects among survivors of childhood cancer.