Minimal long-term cardiopulmonary dysfunction following treatment for Hodgkin's disease

Joanne Watchie, C. Norman Coleman, Thomas A. Raffin, Richards S. Cox, Andrew A. Raubitschek, Thomas Fahey, Richard T. Hoppe, Antonius Van Kessel

Research output: Contribution to journalArticle

Abstract

We studied the long term cardiopulmonary function, at rest and during exercise, of 57 patients who were at least 1 year (mean 5 years) post-treatment for Hodgkin's disease. To establish the maximum degree of dysfunction we studied 40 patients who had extensive intrathoracic disease treated with radiotherapy alone (Exten-X; n = 20) or combined modality therapy (Exten-XC; n = 20). Patients without intrathoracic disease given either prophylactic mantle therapy (Proph-X, n = 10) or no chest irradiation (Control: n = 7) were used as controls. An abnormal electrocardiogram, by virtue of a conduction defect, was observed in seven patients, six in the Exten-X or Exten-XC groups. Borderline abnormalities including ST-T changes, prolonged QT interval, or axis deviation occurred in 14 patients distributed evenly throughout the groups. Resting mean pulmonary function test values were normal in all treatment groups. Exercise tolerance, as indicated by peak oxygen consumption (V02), was significantly lower for the Exten- group compared to Proph-X (p < 0.01). However, the mean value of V02 for group Exten-XC was only 15% below that predicted. Of the 12 patients with abnormally low V02 (>20% below their predicted value), 11 were in the Exten-X or Exten-XC group with no difference between the two groups. Patients who received radiotherapy to at least one lung field, using either the thin lung block technique or open field irradiation, had significantly lower exercise tolerance than those treated with full thickness blocks (p < 0.05). Despite these abnormalities only a single patient complained of marked dyspnea. We conclude that extensive treatment to the mantle field, especially when followed by chemotherapy in patients with extensive intrathoracic Hodgkin's disease, can result in minimal cardiopulmonary dysfunction in approximately one-third of patients.

Original languageEnglish (US)
Pages (from-to)517-524
Number of pages8
JournalInternational journal of radiation oncology, biology, physics
Volume13
Issue number4
DOIs
StatePublished - Apr 1987

Keywords

  • Cardiac function
  • Chemotherapy
  • Exercise
  • Hodgkin's disease
  • Late effects of treatment
  • Pulmonary function
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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  • Cite this

    Watchie, J., Norman Coleman, C., Raffin, T. A., Cox, R. S., Raubitschek, A. A., Fahey, T., Hoppe, R. T., & Van Kessel, A. (1987). Minimal long-term cardiopulmonary dysfunction following treatment for Hodgkin's disease. International journal of radiation oncology, biology, physics, 13(4), 517-524. https://doi.org/10.1016/0360-3016(87)90066-6