Pulmonary complications of childhood cancers

Abstract

Pulmonary complications are frequently seen in survivors of childhood cancer, and are due to both disease-related and treatment-related causes. While primary lung cancer is extremely rare in the pediatric population, the lung is a common site for metastatic disease. Furthermore, therapies used to treat the pediatric population can often cause pulmonary toxicity. Specifically, chemotherapy, radiation, hematopoietic stem cell transplant, and surgery can all cause long-term damage to the sensitive lung tissue. These pulmonary sequelae can be further subdivided into acute and late effects.

Keywords::

• chemotherapy
• childhood cancer
• hematopoietic stem cell transplant
• late effect
• pulmonary complication
• radiation
• treatment

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Improved therapies for childhood cancers have lead to improved survival.

• Early pulmonary complications from cancer therapy are generally observed within the first 6 months.

• Late pulmonary complication can occur from roughly 6 months post therapy to several decades later.

• Radiation therapy can cause both early and late pulmonary complications.

• Chemotherapy can cause both early and late pulmonary complications.

• Combination therapy with both chemotherapy and radiation therapy can result in a greater complication rate.

• Pulmonary lung function testing can be abnormal after therapy.

• Further understanding of the pathophysiology of cancer therapies is needed to continue to improve outcomes and decrease pulmonary complications.