Kasteler, Rahel and Kam, Linda M. H. and Weiss, Annette and Waespe, Nicolas and Sommer, Grit and Singer, Florian and von der Weid, Nicolas X. and Ansari, Marc and Kuehni, Claudia E. (2018) Monitoring pulmonary health in Swiss childhood cancer survivors. PEDIATRIC BLOOD & CANCER, 65 (10): e27255. ISSN 1545-5009, 1545-5017
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BackgroundChildhood cancer survivors are at increased risk for pulmonary morbidity and mortality. International guidelines recommend pulmonary function tests (PFT) during follow-up care. This nationwide study assessed how many children received PFT within 5 years after pulmotoxic treatment in Switzerland, types of tests, and predictors for testing. MethodsWe included all children from the Swiss Childhood Cancer Registry who were diagnosed with cancer from 1990 to 2013 at age 0-16 years, survived for 2 years from diagnosis, and had pulmotoxic chemotherapy with bleomycin, busulfan, nitrosoureas, and/or chest radiotherapy. We searched medical records in all Swiss pediatric oncology clinics for PFT (spirometry, plethysmography, diffusion capacity of carbon monoxide [DLCO]) and treatment details. ResultsWe found medical records for 372 children, of whom 147 had pulmotoxic chemotherapy and 323 chest radiotherapy. Only 185 had plethysmography and/or spirometry (50%), 122 had DLCO (33%). Testing varied by cancer center from 3% to 79% (P=0.001). Central nervous system tumor survivors and those not treated according to study protocols had less plethysmography and/or spirometry (odds ratio (OR) 0.3 and 0.3), lymphoma survivors and those who were symptomatic had more PFT (plethysmography and/or spirometry: OR 5.9 and 8.7; DLCO: OR 3.4 and 2.3). Cumulative incidence (CuI) of PFT was 52% in the first 5 years after pulmotoxic treatment; most of the tests were done in the first 2 years after treatment (CuI 44%). ConclusionOnly half of the survivors exposed to pulmotoxic treatment have been followed up with PFT in Switzerland. We need to optimize, update, and implement monitoring guidelines.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TERM-FOLLOW-UP; COMPLICATIONS; SWITZERLAND; MORTALITY; childhood cancer survivors; Europe; lung function measurements; pulmotoxic; Swiss Childhood Cancer Registry |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Institut für Epidemiologie und Präventivmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Dec 2019 10:35 |
| Last Modified: | 11 Dec 2019 10:35 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13817 |
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