Monitoring pulmonary health in Swiss childhood cancer survivors.

Kasteler, Rahel; Kam, Linda; Weiss, Annette; Waespe, Nicolas; Sommer, Grit; Singer, Florian; von der Weid, Nicolas X; Ansari, Marc; Kuehni, Claudia E; Oncology Group (SPOG), Swiss Pediatric (2018). Monitoring pulmonary health in Swiss childhood cancer survivors. Pediatric blood & cancer, 65(10), e27255. Wiley-Liss 10.1002/pbc.27255

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Childhood cancer survivors are at increased risk for pulmonary morbidity and mortality. International guidelines recommend pulmonary function tests (PFT) during follow-up care. This nationwide study assessed how many children received PFT within 5 years after pulmotoxic treatment in Switzerland, types of tests, and predictors for testing.


We included all children from the Swiss Childhood Cancer Registry who were diagnosed with cancer from 1990 to 2013 at age 0-16 years, survived for ≥2 years from diagnosis, and had pulmotoxic chemotherapy with bleomycin, busulfan, nitrosoureas, and/or chest radiotherapy. We searched medical records in all Swiss pediatric oncology clinics for PFT (spirometry, plethysmography, diffusion capacity of carbon monoxide [DLCO]) and treatment details.


We found medical records for 372 children, of whom 147 had pulmotoxic chemotherapy and 323 chest radiotherapy. Only 185 had plethysmography and/or spirometry (50%), 122 had DLCO (33%). Testing varied by cancer center from 3% to 79% (P = 0.001). Central nervous system tumor survivors and those not treated according to study protocols had less plethysmography and/or spirometry (odds ratio (OR) 0.3 and 0.3), lymphoma survivors and those who were symptomatic had more PFT (plethysmography and/or spirometry: OR 5.9 and 8.7; DLCO: OR 3.4 and 2.3). Cumulative incidence (CuI) of PFT was 52% in the first 5 years after pulmotoxic treatment; most of the tests were done in the first 2 years after treatment (CuI 44%).


Only half of the survivors exposed to pulmotoxic treatment have been followed up with PFT in Switzerland. We need to optimize, update, and implement monitoring guidelines.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Kasteler, Rahel, Kam, Linda Moli-Hua, Weiss, Annette Gerda, Wäspe, Nicolas Thomas, Sommer, Grit, Singer, Florian, Kühni, Claudia


300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health








Anette van Dorland

Date Deposited:

21 Jun 2018 14:17

Last Modified:

05 Dec 2022 15:14

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Europe Swiss Childhood Cancer Registry childhood cancer survivors lung function measurements pulmotoxic




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