초록접수 현황
| 17F-244 | 구연 미채택시 포럼 발표 |
Diffusing Capacity(DLco) Decrement following Neoadjuvant Concurrent Chemoradiotherapy : Implication on Postoperative Pulmonary Complications in Lung Cancer Patients.
Sumin Shin, Yong Soo Choi, Jae Jun Jung, Jong Ho Cho, Hong Kwan Kim, Jhingook Kim, Jae Ill Zo, Kwhanmien Kim, Young Mog Shim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : The aim of this study was to evaluate the effect of neoadjuvant concurrent chemoradiotherapy (CCRT) on pulmonary functions and postoperative pulmonary complications (PPCs) in patients who underwent surgical resection for non-small cell lung cancer(NSCLC).
Methods : We retrospectively reviewed patients with NSCLC who underwent neoadjuvant CCRT followed by surgery between 2009 and 2016. Of those, 327 patients who had pulmonary function test both before and after neoadjuvant treatment were included in the study. The PPCs were defined as more than grade II Clavien-Dindo classification.
Results : Chemoradiotherapy was associated with significant worsening of the predicted value of diffusing capacity of carbon monoxide(DLco), which decreased a mean of 12.7% (p<0.001). While, the mean change in the functional vital capacity(FVC), predicted forced expiratory volume in 1 second(FEV1) and FVC/FEV1 after CCRT was not significant. A total of 81 patients(25%) developed at least one PPC. Acute respiratory distress syndrome(n=38) and pneumonia(n=37) were the two most frequent PPCs, followed by respiratory failure (n=24). The incidence of PPC was significantly more common for DLco reduction of both pre-(normal vs mild vs moderate, 16 vs 36 vs 42%, p<0.001) and post-CCRT (14 vs 26 vs 39%, p<0.001). Regardless of worsening of DLco after CCRT, the incidence of PPCs was more likely to correlated with pre-CCRT DLco except patients with moderate reduction of DLco.
Conclusion : Neoadjuvant CCRT impair pulmonary functions, especially the diffusing capacity. Diffusing capacity before or after CCRT may predict the risk of PPCs, repeated test would be considered to proper risk assessment.
Methods : We retrospectively reviewed patients with NSCLC who underwent neoadjuvant CCRT followed by surgery between 2009 and 2016. Of those, 327 patients who had pulmonary function test both before and after neoadjuvant treatment were included in the study. The PPCs were defined as more than grade II Clavien-Dindo classification.
Results : Chemoradiotherapy was associated with significant worsening of the predicted value of diffusing capacity of carbon monoxide(DLco), which decreased a mean of 12.7% (p<0.001). While, the mean change in the functional vital capacity(FVC), predicted forced expiratory volume in 1 second(FEV1) and FVC/FEV1 after CCRT was not significant. A total of 81 patients(25%) developed at least one PPC. Acute respiratory distress syndrome(n=38) and pneumonia(n=37) were the two most frequent PPCs, followed by respiratory failure (n=24). The incidence of PPC was significantly more common for DLco reduction of both pre-(normal vs mild vs moderate, 16 vs 36 vs 42%, p<0.001) and post-CCRT (14 vs 26 vs 39%, p<0.001). Regardless of worsening of DLco after CCRT, the incidence of PPCs was more likely to correlated with pre-CCRT DLco except patients with moderate reduction of DLco.
Conclusion : Neoadjuvant CCRT impair pulmonary functions, especially the diffusing capacity. Diffusing capacity before or after CCRT may predict the risk of PPCs, repeated test would be considered to proper risk assessment.
책임저자: Yong Soo Choi
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Sumin Shin, E-mail : essennee@gmail.com