Objective  To investigate the value of cardiopulmonary exercise testing (CPET) in the cardiopulmonary functional assessment of lung cancer patients before and after radiotherapy.

Methods  Lung cancer patients who were to undergo radiotherapy in the radiotherapy department of Xuzhou Central Hospital from July 2020 to December 2022 were included, and CPET (including static lung function) were performed one day before and one week after radiotherapy. The core indexes, circulatory indexes, respiratory indexes and static lung function indexes in the resting phase, warm-up phase, anaerobic threshold phase, limiting phase and recovery 3 min phase were derived from the test system. The results of data analysis were used to assess the overall functional changes of lung cancer patients before and after radiotherapy.

Results  A total of 45 patients with lung cancer were enrolled. After radiotherapy, among the core indexes, the anaerobic threshold as a percentage of predicted value (AT%pred), and peak oxygen pulse were lower (P<0.05) and the carbon dioxide ventilation equivalent slope was higher in lung cancer patients after radiotherapy than those before radiotherapy, with statistically significant differences (P<0.05). Among the circulatory indexes, heart rate at rest, warm-up, anaerobic threshold, limit, and recovery 3 min states and carbon dioxide ventilation equivalent at rest, anaerobic threshold, limit, and recovery 3 min states were significantly higher in patients with lung cancer compared with those prior to radiotherapy (P<0.05), and oxygen pulse at rest, warm-up, anaerobic threshold and limit state were significantly lower than before radiotherapy (P<0.05). Among the respiratory indexes, the partial pressure of carbon dioxide at rest, warm-up, anaerobic threshold, and limit states was lower (P<0.05) and the partial pressure of oxygen at warm-up and anaerobic threshold states was higher (P<0.05) than those before radiotherapy. There was no statistically significant difference in the changes of static lung function indexes before and after radiotherapy.

Conclusion  The cardiopulmonary function of lung cancer patients after radiotherapy is lower than that before radiotherapy, especially the damage of circulatory function and cell metabolism. CPET, as a diagnostic method, can be used to evaluate the cardiopulmonary function of lung cancer patients before and after radiotherapy.

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