Lung clearance index: a new measure of late lung complications of cancer
therapy in children
Abstract
Introduction Childhood cancer survivors (CSs) might face an increased
lifelong risk of lung function impairment. The Lung Clearance Index
(LCI) has been described as being more sensitive than spirometry in the
early stages of some lung diseases. The aim of this study was to
evaluate this index in a cohort of patients with a history of childhood
cancer for the first time. Materials and Methods We evaluated 57
off-treatment CSs aged 0–18 years old and 50 healthy controls (HCs). We
used the multiple breath washout (MBW) method to study LCI and
spirometry. Results CSs did not show any differences from the controls
in ventilation homogeneity (LCI 6.78 ± 1.35 vs. 6.32 ± 0.44, P: ns) or
lung function (FEV1 99.9 ± 11.3% vs. 103.0 ± 5.9% of predicted, P: ns;
FVC 98.2 ± 10.3% vs. 101.1 ± 3.3% of predicted). LCI significantly
correlated with the number of years since the last chemotherapy (r =
0.35, P < 0.05). Conclusions Our study describes the trend of
LCI in a cohort of CSs and compares it with the results obtained from
healthy controls. The results show that patients maintain both good
values of respiratory function and good homogeneity of ventilation
during childhood. Moreover, the LCI identifies the tendency toward
pulmonary fibrosis, which is typical of adult CSs, at an earlier time
than spirometry.