Kasteler R, et al. - This study was meant to evaluate the prevalence and incidence of pulmonary diseases in long-term childhood cancer survivors (CCS) and their siblings. Collected evidence displayed an increased risk for pulmonary diseases, especially pneumonia in these subjects. These findings highlighted the requirement for long-term pulmonary follow-up in CCS.

Methods

• As part of the Swiss Childhood Cancer Survivor Study, the authors studied CCS who were diagnosed between 1976 and 2005 and alive at least 5 years after diagnosis.
• They compared prevalence of self-reported pulmonary diseases (pneumonia, chest wall abnormalities, lung fibrosis, emphysema) between CCS and their siblings, calculated cumulative incidence of pulmonary diseases using the Kaplan–Meier method.
• With the aid of multivariable logistic regression risk factors were evaluated.

Results

• CCS reported more pneumonias (10% vs. 7%, P = 0.020) and chest wall abnormalities (2% vs. 0.4%, P = 0.003) than siblings.
• Treatment with busulfan was associated with prevalence of pneumonia (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.1–14.9), and thoracic surgery was associated with chest wall abnormalities and lung fibrosis (OR 4.1, 95% CI 1.6–10.7 and OR 6.3, 95% CI 1.7–26.6).
• Accumulated showed that cumulative incidence of any pulmonary disease after 35 years of follow-up was 21%.
• For pneumonia, the highest cumulative incidence was seen in CCS treated with both pulmotoxic chemotherapy and radiotherapy to the thorax (23%).