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Pulmonary Function Alterations After Induction Therapy for Lung Cancer: Preoperative Considerations

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Difficult Decisions in Thoracic Surgery

Abstract

Neoadjuvant chemotherapy or chemoradiotherapy prior to surgery offers hope for extended survival in patients with regionally advanced non-small cell lung cancer (NSCLC), particularly those patients with ipsilateral mediastinal nodal involvement. However, neoadjuvant therapies are sometimes associated with pulmonary toxicity. A recent large scale analysis using the Society of Thoracic Surgery (STS) General Thoracic Surgery Database identified induction therapy as an independent predictor of postoperative pulmonary complications.1 The present chapter reviews the effects of neoadjuvant therapy on pulmonary function as well as perioperative morbidity and mortality, and examines whether altering the timing of resection can reduce the risk of complications.

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References

  1. Ferguson MK, Gaissert HA, Grab JD, Sheng S. Pulmonary complications after lung resection in the absence of chronic obstructive pulmonary disease: The predictive role of diffusing capacity. J Thorac Cardiovasc Surg. 2009;138:1297–1302.

    Google Scholar 

  2. Roth JA, Fossella F, Komaki R et al. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. J Natl Cancer Inst. 1994;86:673–680.

    Article  PubMed  CAS  Google Scholar 

  3. Roth JA, Atkinson EN, Fossella F et al. Long-term follow-up of patients enrolled in a randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. Lung Cancer. 1998;21:1–6.

    Article  PubMed  CAS  Google Scholar 

  4. Rosell R, Gomez-Codina J, Camps C, et al. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer. N Engl J Med. 1994;330:153–158.

    Article  PubMed  CAS  Google Scholar 

  5. Rosell R, Gomez-Codina J, Camps C et al. Preresectional chemotherapy in stage IIIA non-small-cell lung cancer: a 7-year assessment of a randomized controlled trial. Lung Cancer. 1999;26:7–14.

    Article  PubMed  CAS  Google Scholar 

  6. Castro M, Veeder MH, Mailliard JA, Tazelaar HD, Jett JR. A prospective study of pulmonary function in patients receiving mitomycin. Chest. 1996;109:939–944.

    Article  PubMed  CAS  Google Scholar 

  7. Dimopoulou I, Galani H, Dafni U, Samakovii A, Roussos C, Dimopoulos MA. A prospective study of pulmonary function in patients treated with paclitaxel and carboplatin. Cancer. 2002;94:452–458.

    Article  PubMed  CAS  Google Scholar 

  8. Bhalla KS, Wilczynski SW, Abushamaa AM et al. Pulmonary toxicity of induction chemotherapy prior to standard or high-dose chemotherapy with autologous hematopoietic support. Am J Respir Crit Care Med. 2000;161:17–25.

    Article  PubMed  CAS  Google Scholar 

  9. Rivera MP, Detterbeck FC, Socinski MA et al. Impact of preoperative chemotherapy on pulmonary function tests in resectable early-stage non-small cell lung cancer. Chest. 2009;135:1588–1595.

    Article  PubMed  Google Scholar 

  10. Choi NC, Kanarek DJ. Toxicity of thoracic radiotherapy on pulmonary function in lung cancer. Lung Cancer. 1994;10(suppl 1):S219–S230.

    Article  PubMed  Google Scholar 

  11. Fan M, Marks LB, Hollis D et al. Can we predict radiation-induced changes in pulmonary function based on the sum of predicted regional dysfunction? J Clin Oncol. 2001;19:543–550.

    PubMed  CAS  Google Scholar 

  12. De Jaeger K, Seppenwoolde Y, Boersma LJ et al. Pulmonary function following high-dose radiotherapy of non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2003;55:1331–1340.

    Article  PubMed  Google Scholar 

  13. Mehta V. Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer: pulmonary function, prediction, and prevention. Int J Radiat Oncol Biol Phys. 2005;63:5–24.

    Article  PubMed  Google Scholar 

  14. Videtic GM, Stitt LW, Ash RB et al. Impaired diffusion capacity predicts for decreased treatment tolerance and survival in limited stage small cell lung cancer patients treated with concurrent chemoradiation. Lung Cancer. 2004;43:159–166.

    Article  PubMed  Google Scholar 

  15. Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 suppl):161S–177S.

    Article  PubMed  Google Scholar 

  16. Deslauriers J, Ginsberg RJ, Dubois P, Beaulieu M, Goldberg M, Piraux M. Current operative morbidity associated with elective surgical resection for lung cancer. Can J Surg. 1989;32:335–339.

    PubMed  CAS  Google Scholar 

  17. Ferguson MK, Vigneswaran WT. Diffusing capacity predicts morbidity after lung resection in patients without obstructive lung disease. Ann Thorac Surg. 2008;85:1158–1165.

    Article  PubMed  Google Scholar 

  18. Matsubara Y, Takeda S, Mashimo T. Risk stratification for lung cancer surgery: impact of induction therapy and extended resection. Chest. 2005;128:3519–3525.

    Article  PubMed  Google Scholar 

  19. Leo F, Pelosi G, Sonzogni A, Chilosi M, Bonomo G, Spaggiari L. Structural lung damage after chemotherapy fact or fiction? Lung Cancer. May 26, 2009. [Epub ahead of print]

    Google Scholar 

  20. Roberts JR, Eustis C, Devore R, Carbone D, Choy H, Johnson D. Induction chemotherapy increases perioperative complications in patients undergoing resection for non-small cell lung cancer. Ann Thorac Surg. September 2001;72:885–888.

    Article  PubMed  CAS  Google Scholar 

  21. Leo F, Solli P, Spaggiari L et al. Respiratory function changes after chemotherapy: an additional risk for postoperative respiratory complications? Ann Thorac Surg. 2004;77:260–265.

    Article  PubMed  Google Scholar 

  22. Martin J, Ginsberg RJ, Abolhoda A et al. Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg. 2001;72:1149–1154.

    Article  PubMed  CAS  Google Scholar 

  23. Brouchet L, Bauvin E, Marcheix B et al. Impact of induction treatment on postoperative complications in the treatment of non-small cell lung cancer. J Thorac Oncol. 2007;2:626–631.

    Article  PubMed  Google Scholar 

  24. Gaissert HA, Keum DY, Wright CD et al. POINT: Operative risk of pneumonectomy--influence of preoperative induction therapy. J Thorac Cardiovasc Surg. 2009;138:289–294.

    Article  PubMed  Google Scholar 

  25. Cerfolio RJ, Talati A, Bryant AS. Changes in pulmonary function tests after neoadjuvant therapy predict postoperative complications. Ann Thorac Surg. 2009;88:930–936.

    Article  PubMed  Google Scholar 

  26. Takeda S, Funakoshi Y, Kadota Y et al. Fall in diffusing capacity associated with induction therapy for lung cancer: a predictor of postoperative complication? Ann Thorac Surg. 2006;82:232–236.

    Article  PubMed  Google Scholar 

  27. Sleijfer S, van der Mark TW, Schraffordt Koops H, Mulder NH. Decrease in pulmonary function during bleomycin-containing combination chemotherapy for testicular cancer: not only a bleomycin effect. Br J Cancer. 1995;71:120–123.

    Article  PubMed  CAS  Google Scholar 

  28. Todd NW, Peters WP, Ost AH, Roggli VL, Piantadosi CA. Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation. Am Rev Respir Dis. 1993;147:1264–1270.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA

    Gabriel Loor

  2. Department of Surgery, The University of Chicago, Chicago, IL, USA

    Mark K. Ferguson

Authors
  1. Gabriel Loor
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  2. Mark K. Ferguson
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Editor information

Editors and Affiliations

  1. Dept. Surgery, Mail Code 5035, University of Chicago, S. Maryland Avenue 5841, Chicago, 60637, Illinois, USA

    Mark K. Ferguson

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© 2011 Springer-Verlag London Limited

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Loor, G., Ferguson, M.K. (2011). Pulmonary Function Alterations After Induction Therapy for Lung Cancer: Preoperative Considerations. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-492-0_10

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  • DOI: https://doi.org/10.1007/978-1-84996-492-0_10

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-364-0

  • Online ISBN: 978-1-84996-492-0

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