Thesis (M.S.) - Minoufiya University. Faculty of Medicine. Chest Diseases & Tuberculosis dept.

Includes bibliographical references (p. 97 - 110)

a) Lung cancer is the leading cause of cancer death worldwide. In 2015, an
estimated 221,200 new cases (115,610 in men and 105,590 in women) of lung
and bronchial cancer will be diagnosed, and 158,040 deaths (86,380 in men and
71,660 in women) are estimated to occur in the United States. Surgery,
radiotherapy, and chemotherapy are the various options available in the
management of lung cancer. In case of non-small cell lung cancer in the early
stages (stage I to IIIA) surgery if feasible is the treatment of choice. The role of
adjuvant chemotherapy is not well established. For metastatic diseases only
palliative treatment either chemo or radiotherapy is feasible.
As the lung is a potential target of drug and especially chemotherapy
toxicity, the effect of adjuvant chemotherapy on pulmonary function needs
further attention. While several trials have focused on the toxic effects of
neoadjuvant chemotherapy on pulmonary function or the course of lung
function after major lung resection without neo-/adjuvant therapy. In addition,
toxicity of radiotherapy occurs both as acute side effects during or within 90
days after the completion of course of irradiation and late complication of
radiation fibrosis develop from 3 to 18 months after radiotherapy.
We aim to assess the incidence of pulmonary complications of radio and
chemotherapy in treatment of lung cancer.
Our results showed that 28% of included subjects developed pulmonary
infections, eight percent developed pulmonary embolism, and only one patient
had respiratory failure throughout the study period. In addition, a higher
96
significant reduction in total leucocyte count was observed among complicated
group compared to non-complicated group. There was no statistically
significant difference between both groups regarding age, sex, occupation,
family and smoking history, or histopathological type.
Interestingly, the baseline pulmonary function tests were significantly
lower among the group with pulmonary complications in comparison to noncomplicated
group. However, no significant differences from baseline
pulmonary function tests were detected among study groups at the end of follow
up. The mortality rate was ١٨% throughout the study period.
In conclusion, the incidence of pulmonary complications among adult
patients with lung cancer who receive different modalities is high. The most
commonly encountered complications are pulmonary infections and pulmonary
embolism. Although pulmonary functions do not decline significantly following
treatment; the baseline pulmonary function parameters can be used for the
prediction of development of pulmonary complications.

Text in English, abstracts in English and Arabic.