Pulmonary function during lung cancer therapy: A retrospective analysis of patients treated with monotherapy or multimodal treatments

Background: Lung cancer patients often have impaired lung function, which limits treatment options and impairs quality of life. Also, treatment may cause further deteriorations in lung function. Here we present an analysis of pulmonary function tests (PFT) in patients treated for lung cancer and examine correlations with treatment type. Methods: We retrospectively analysed 93 patients treated for lung cancer and correlated PFT results over time with type of treatment. Results: 176 PFTs from 55 men and 38 women treated at the Munich Thoracic Oncology Centre were included. Treatment groups were: chemotherapy n=28, other systemic therapy n=3, radiochemotherapy n= 39, radiation n=8, trimodal therapy n=4, surgery n=7, supportive care n=3. Patients treated with surgery or multimodal treatment had better PFTs (FEV1, %predicted FEV1, diffusion capacity and %predicted diffusion capacity) at first diagnosis than those treated with chemotherapy. There was a significant difference in FEV1 (p=0.008) and %predicted FEV (p=0.014) between the therapeutic groups. PFTs often worsened during treatment. At the time of the first follow up patients treated with surgery or multimodal treatment still had a better lung function than patients treated with chemotherapy. Conclusion: There are clinically relevant differences in PFTs before treatment for lung cancer and during the course of treatment in subgroups of lung cancer patients. Patients treated with systemic treatment alone often have poor lung function and may show further deterioration of PFTs during treatment. Larger studies of the effect of individual systemic agents on lung function in this setting are warranted.