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Changes in the pulmonary function test after radioactive iodine treatment in patients with pulmonary metastases of differentiated thyroid cancer.

Jang EK, Kim WG, Kim HC, Huh JW, Kwon H, Choi YM, Jeon MJ, Kim TY, Shong YK, Ryu JS, Kim WB - PLoS ONE (2015)

Bottom Line: The median age of the patients was 44.1 years and 18 of them were female patients.Coexisting pulmonary diseases, presence of respiratory symptoms, and metastatic disease progression were significantly associated with severe decrease in forced vital capacity during follow-up (p =.047, p =.011, and p =.021, respectively).Serial PFT might be considered for some high-risk patients during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea; Division of Endocrinology, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan, Korea.

ABSTRACT

Objective: Pulmonary function test (PFT) is a useful tool for an objective assessment of respiratory function. Impaired pulmonary function is critical for the survival and quality of life in patients with pulmonary metastases of solid cancers including thyroid cancer. This study aimed to evaluate clinical factors associated with severely impaired pulmonary function by serial assessment with PFT in patients with pulmonary metastasis of differentiated thyroid cancer (DTC) who received radioactive iodine treatment (RAIT).

Patients: This retrospective study enrolled 31 patients who underwent serial PFTs before and after RAIT for pulmonary metastasis of DTC. We evaluated the risk factors for severe impairment of pulmonary function.

Results: The median age of the patients was 44.1 years and 18 of them were female patients. Severe impairment of pulmonary function was observed in five patients (16%) after a median of three RAITs (cumulative I-131 activity = 20.4 GBq). These patients were older and more frequently had mild impairment of baseline pulmonary function, respiratory symptoms, or progressive disease compared with patients with stable pulmonary function. Neither cumulative dose nor number of RAIT was associated with decreased pulmonary function. Coexisting pulmonary diseases, presence of respiratory symptoms, and metastatic disease progression were significantly associated with severe decrease in forced vital capacity during follow-up (p =.047, p =.011, and p =.021, respectively).

Conclusions: Pulmonary function was severely impaired during follow-up in some patients with pulmonary metastasis of DTC after a high-dose RAITs. Neither the number of RAIT nor the cumulative I-131 activity was associated with decreased pulmonary function. Serial PFT might be considered for some high-risk patients during follow-up.

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Clinical factors associated with severe impairment of pulmonary function after radioactive iodine treatment.(A) Changes in FVC at baseline and the worst value during follow-up in patients with or without coexisting pulmonary disease. (B) Changes in FVC at baseline and the worst value during follow-up in patients with or without respiratory symptoms. (C) Changes in FVC at baseline and the worst value during follow-up in patients with or without disseminated metastases on chest X-ray (D) Changes in FVC at baseline and the worst value during follow-up in patients with or without progressive disease. %, % of measured to predicted values. FVC, forced vital capacity; Baseline, pulmonary function at baseline; Worst, worst values of pulmonary function during follow-up; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.
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pone.0125114.g002: Clinical factors associated with severe impairment of pulmonary function after radioactive iodine treatment.(A) Changes in FVC at baseline and the worst value during follow-up in patients with or without coexisting pulmonary disease. (B) Changes in FVC at baseline and the worst value during follow-up in patients with or without respiratory symptoms. (C) Changes in FVC at baseline and the worst value during follow-up in patients with or without disseminated metastases on chest X-ray (D) Changes in FVC at baseline and the worst value during follow-up in patients with or without progressive disease. %, % of measured to predicted values. FVC, forced vital capacity; Baseline, pulmonary function at baseline; Worst, worst values of pulmonary function during follow-up; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.

Mentions: The presence of coexisting pulmonary disease was significantly associated with decreased FVC and FEV1 in serial PFTs (Fig 2A). The median FVC at baseline PFT in patients with coexisting pulmonary disease (n = 5) was 91.0%, which decreased to 80.0% during follow-up after RAIT (p =. 07). In patients without coexisting pulmonary disease (n = 26), the median FVC changed from 88.5% to 87.0% during follow-up (p =. 29).The decrease in the FVC was more significant in patients with coexisting pulmonary disease than in those without coexisting pulmonary disease (p =. 009; Fig 2A and S1 Table). FEV1significantly decreased during follow-up in patients with coexisting pulmonary disease (from 103.0% to 65.0%, p =. 031) and in patients without coexisting pulmonary disease (from 91.5% to 87.0%, p =. 038).The decrease in the FEV1was more significant in patients with coexisting pulmonary disease than in those without coexisting pulmonary disease (p =. 016; S2 Table & S1 Fig). There was no significant difference in the FEV1/FVC change during follow-up between the two groups (p =. 79; S3 Table).


Changes in the pulmonary function test after radioactive iodine treatment in patients with pulmonary metastases of differentiated thyroid cancer.

Jang EK, Kim WG, Kim HC, Huh JW, Kwon H, Choi YM, Jeon MJ, Kim TY, Shong YK, Ryu JS, Kim WB - PLoS ONE (2015)

Clinical factors associated with severe impairment of pulmonary function after radioactive iodine treatment.(A) Changes in FVC at baseline and the worst value during follow-up in patients with or without coexisting pulmonary disease. (B) Changes in FVC at baseline and the worst value during follow-up in patients with or without respiratory symptoms. (C) Changes in FVC at baseline and the worst value during follow-up in patients with or without disseminated metastases on chest X-ray (D) Changes in FVC at baseline and the worst value during follow-up in patients with or without progressive disease. %, % of measured to predicted values. FVC, forced vital capacity; Baseline, pulmonary function at baseline; Worst, worst values of pulmonary function during follow-up; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4414613&req=5

pone.0125114.g002: Clinical factors associated with severe impairment of pulmonary function after radioactive iodine treatment.(A) Changes in FVC at baseline and the worst value during follow-up in patients with or without coexisting pulmonary disease. (B) Changes in FVC at baseline and the worst value during follow-up in patients with or without respiratory symptoms. (C) Changes in FVC at baseline and the worst value during follow-up in patients with or without disseminated metastases on chest X-ray (D) Changes in FVC at baseline and the worst value during follow-up in patients with or without progressive disease. %, % of measured to predicted values. FVC, forced vital capacity; Baseline, pulmonary function at baseline; Worst, worst values of pulmonary function during follow-up; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.
Mentions: The presence of coexisting pulmonary disease was significantly associated with decreased FVC and FEV1 in serial PFTs (Fig 2A). The median FVC at baseline PFT in patients with coexisting pulmonary disease (n = 5) was 91.0%, which decreased to 80.0% during follow-up after RAIT (p =. 07). In patients without coexisting pulmonary disease (n = 26), the median FVC changed from 88.5% to 87.0% during follow-up (p =. 29).The decrease in the FVC was more significant in patients with coexisting pulmonary disease than in those without coexisting pulmonary disease (p =. 009; Fig 2A and S1 Table). FEV1significantly decreased during follow-up in patients with coexisting pulmonary disease (from 103.0% to 65.0%, p =. 031) and in patients without coexisting pulmonary disease (from 91.5% to 87.0%, p =. 038).The decrease in the FEV1was more significant in patients with coexisting pulmonary disease than in those without coexisting pulmonary disease (p =. 016; S2 Table & S1 Fig). There was no significant difference in the FEV1/FVC change during follow-up between the two groups (p =. 79; S3 Table).

Bottom Line: The median age of the patients was 44.1 years and 18 of them were female patients.Coexisting pulmonary diseases, presence of respiratory symptoms, and metastatic disease progression were significantly associated with severe decrease in forced vital capacity during follow-up (p =.047, p =.011, and p =.021, respectively).Serial PFT might be considered for some high-risk patients during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea; Division of Endocrinology, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan, Korea.

ABSTRACT

Objective: Pulmonary function test (PFT) is a useful tool for an objective assessment of respiratory function. Impaired pulmonary function is critical for the survival and quality of life in patients with pulmonary metastases of solid cancers including thyroid cancer. This study aimed to evaluate clinical factors associated with severely impaired pulmonary function by serial assessment with PFT in patients with pulmonary metastasis of differentiated thyroid cancer (DTC) who received radioactive iodine treatment (RAIT).

Patients: This retrospective study enrolled 31 patients who underwent serial PFTs before and after RAIT for pulmonary metastasis of DTC. We evaluated the risk factors for severe impairment of pulmonary function.

Results: The median age of the patients was 44.1 years and 18 of them were female patients. Severe impairment of pulmonary function was observed in five patients (16%) after a median of three RAITs (cumulative I-131 activity = 20.4 GBq). These patients were older and more frequently had mild impairment of baseline pulmonary function, respiratory symptoms, or progressive disease compared with patients with stable pulmonary function. Neither cumulative dose nor number of RAIT was associated with decreased pulmonary function. Coexisting pulmonary diseases, presence of respiratory symptoms, and metastatic disease progression were significantly associated with severe decrease in forced vital capacity during follow-up (p =.047, p =.011, and p =.021, respectively).

Conclusions: Pulmonary function was severely impaired during follow-up in some patients with pulmonary metastasis of DTC after a high-dose RAITs. Neither the number of RAIT nor the cumulative I-131 activity was associated with decreased pulmonary function. Serial PFT might be considered for some high-risk patients during follow-up.

Show MeSH
Related in: MedlinePlus