Criteria for restrictive lung disease:
(1) ratio of observed to predicted FVC < 80%
(2) FEV1 to FVC ratio >= 70%
Risk factors for restrictive lung disease:
(1) age > 40 years at diagnosis
(2) undergoing both cisplatin therapy and pulmonary surgery
(3) high cumulative dose of cisplatin (> 850 mg)
Other factors to consider:
(1) A history of smoking was associated with a reduced ratio of observed to predicted FVC.
(2) Asthma may contribute to dyspnea.
Differential diagnosis of worsening pulmonary function:
(1) recurrent disease
(2) high tumor burden in the lungs
(3) obstructive lung disease associated with smoking
The pulmonary function of a man undergoing cisplatin chemotherapy for testicular cancer should be included in long-term monitoring for complications. A patient who is smoking should be encouraged to quit. The patient should be encouraged to exercise and to maintain a healthy weight.
