儿童癌症幸存者由于接触肺毒性治疗（包括特定的化疗、放疗和手术）而面临肺部发病的风险。有关肺功能及其随时间变化的纵向数据很少。我们调查了幸存者随时间推移的肺功能轨迹以及与肺毒性治疗的关系。这项回顾性、多中心队列研究包括 1990 年至 2013 年间诊断并接受肺毒性化疗或胸部放疗的瑞士幸存者。肺功能测试 (PFT)，包括第一秒用力呼气量 (FEV1)、用力肺活量 (FVC)、FEV1/FVC、肺总量和肺一氧化碳扩散能力，均通过医院图表获得。我们计算了 z 分数和预测百分比，描述了肺功能随时间的变化，并使用多变量线性回归确定了 FEV1 和 FVC 变化的危险因素。我们纳入了 183 名幸存者的 790 名 PFT，诊断时的中位年龄为 12 岁，诊断时的中位年龄为 5.5 岁的后续行动。最常见的诊断是淋巴瘤（55%）。一半（49%）的幸存者至少有一项肺功能参数异常，主要是限制性的（22%）。 FEV1 和 FVC 的轨迹在诊断时从 z 分数 -1.5 开始，并在整个随访过程中保持较低水平。与未接受手术的幸存者相比，接受胸部手术治疗的幸存者开始时特别低，FEV1 为 -1.08 z 得分（-2.02 至 -0.15），FVC 为 -1.42 z 得分（-2.27 至 -0.57）。 肺功能下降很常见，但主要是轻度至中度严重程度。尽管如此，仍需要对这一弱势群体进行更多研究和长期监测。© 2023 Wiley periodicals LLC。

Childhood cancer survivors are at risk for pulmonary morbidity due to exposure to lung-toxic treatments, including specific chemotherapeutics, radiotherapy, and surgery. Longitudinal data on lung function and its change over time are scarce. We investigated lung function trajectories in survivors over time and the association with lung-toxic treatments.This retrospective, multicenter cohort study included Swiss survivors diagnosed between 1990 and 2013 and exposed to lung-toxic chemotherapeutics or thoracic radiotherapy. Pulmonary function tests (PFTs), including forced expiration volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, total lung capacity,  and diffusion capacity of the lung for carbon monoxide, were obtained from hospital charts. We calculated z-scores and percentage predicted, described lung function over time, and determined risk factors for change in FEV1 and FVC using multivariable linear regression.We included 790 PFTs from 183 survivors, with a median age of 12 years at diagnosis and 5.5 years of follow-up. Most common diagnosis was lymphoma (55%). Half (49%) of survivors had at least one abnormal pulmonary function parameter, mainly restrictive (22%). Trajectories of FEV1 and FVC started at z-scores of -1.5 at diagnosis and remained low throughout follow-up. Survivors treated with thoracic surgery started particularly low, with an FEV1 of -1.08 z-scores (-2.02 to -0.15) and an FVC of -1.42 z-scores (-2.27 to -0.57) compared to those without surgery.Reduced pulmonary function was frequent but mainly of mild to moderate severity. Nevertheless, more research and long-term surveillance of this vulnerable population is needed.© 2023 Wiley Periodicals LLC.