• Tseng Tien Huang, Yan Chen, Andrew C Dietz, Yutaka Yasui, Sarah S Donaldson, Dennis C Stokes, Marilyn Stovall, Wendy M Leisenring, Charles A Sklar, Lisa R Diller, Ann C Mertens, Gregory T Armstrong, Daniel M Green, Leslie L Robison, and Kirsten K Ness.
• Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee.
• Pediatr Blood Cancer. 2014 Feb 1; 61 (2): 319-25.

BackgroundAdult survivors of childhood central nervous system (CNS) tumors may be at risk for pulmonary dysfunction. This study enumerates the incidence of pulmonary dysfunction and explores associations between craniospinal irradiation (CSI) and pulmonary dysfunction among survivors of childhood CNS tumors.MethodsParticipants included Childhood Cancer Survivor Study (CCSS) cohort members treated for CNS malignancies when ResultsSurvivor participants (N = 1,653) were 54.7% male, median age at diagnosis 7.6 (range 0-21), and median time from cohort entry 18.5 (range 3.3-33.9) years. The incidence of pulmonary dysfunction (per 1,000 person years) was 9.1 (95% CI 7.8-10.6) for emphysema/obliterative bronchiolitis and >3.0 for asthma, chronic cough and need for extra oxygen. Rates of fibrosis (RR 2.0, 95% CI 1.0-3.9), chest wall abnormalities (RR 19.0, 95% CI 4.2-85.7), chronic cough (RR 1.6, 95% CI 1.2-2.1) and need for supplemental oxygen (RR 2.5, 95% CI 1.9-3.3) were higher among survivors than among siblings. Survivors treated with CSI were 10.4 (95% CI 7.6-14.4) times more likely than those not exposed to report chest wall deformity.ConclusionAdult survivors of CNS malignancy have high rates of pulmonary dysfunction 5+ years after diagnosis. Survivors treated with CSI should be monitored for pulmonary disease to permit early interventions.© 2013 Wiley Periodicals, Inc.

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