Evaluation of Long Term Respiratory Complications in Childhood and Adolescent Cancer Survivors

INTRODUCTION: Beside the increased survival rates systemic complications that can impair the quality of life have been seen in 25-30% at childhood and adolescent cancer. Respiratory system is one of the severely affected systems. We aimed to evaluate late respiratory complications and risk factors in pediatric and adolescent cancers.
METHODS: We examined the pulmonary complications of 50 cancer patients and 40 control cases. We asked about environmental exposures, performed physical examination, and pulmonary function tests (PFT) (spirometry, DLCO). X-ray was performed on all patients in the patient group and on patients with indication in the control group
RESULTS: In the patient group there was impairment of pulmonary function in 52%, (24% small airway disease, 14 % diffusion disorders (DD) and 14% combined disorder(CD) compared to 22,5% in the control group (p: 0,007). There was a higher risk of restrictive disorder and/or small airway disease (SAD) in cancer patients who were diagnosed prior to 2 years of age. Besides thare was a higher rate of SAD in patients with soft tissue sarcomas and a higher rate of restrictive disease in patients who had received high-dose alkylating agents. No significant PFT impairment was observed in other patient groups.
DISCUSSION AND CONCLUSION: There is a high incidence of respiratory impairment in childhood and adolescent cancer survivors. They need to be followed-up by a multidisciplinary team and be informed about additional risk factors which may cause lung function loss.