Exercise in Patients with Non-Small Cell Lung Cancer
Exercise in Patients with Non-Small Cell Lung Cancer
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DOI：
10.1249/mss.0000000000000158
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发表时间：
2014-04-01
期刊：
影响因子：
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通讯作者：
Thomas, Michael
中科院分区：
文献类型：
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作者：
Kuehr, Lea;Wiskemann, Joachim;Thomas, Michael
目的评价8wk抗阻耐力锻炼方案在晚期非小细胞肺癌(NSCLC)患者住院和门诊治疗中的安全性、可行性和疗效。在8wk期间，患者被指导在住院期间每周至少锻炼五次，在门诊环境中每周至少锻炼三次。在基线(T0)、运动干预后(T1)和8wk后的随访时间点(T2)评估体能状态(耐力：6分钟步行试验；力量：手持测力仪)、生活质量(癌症治疗功能评估-肺)、疲劳(多维疲劳量表)和抑郁(患者健康问卷)。主要终点是足够的依从性(可行性)，即在至少6周内每周至少完成两次训练。结果40名患者中，31名(77.5%)完成了运动后评估(T1)，22名(55%)完成了随访(T2)。分期为IIA(5%)、IIIA(8%)、IIIB(20%)、IV(67%)，中位年龄63岁(22~75岁)。总体而言，完成T1的患者的依从性为82%，40名参与患者中55%的患者达到了适当的依从性标准。完成干预的患者在干预后的6分钟步行距离以及膝关节、肘部和臀部肌肉力量方面均有显著改善(T1)。生活质量、疲劳和抑郁得分保持稳定或略有下降。T2时膝关节肌力也有明显改善。结论运动训练对晚期和转移性非小细胞肺癌患者抗癌治疗是可行的。在这项先导性研究中，耐力和力量能力随着时间的推移而提高，表明了应用干预的康复重要性。为了研究运动训练对这组患者的潜在影响，有必要进行一项更大规模的随机试验。
Purpose This study aimed to evaluate the safety, feasibility, and effects of an 8-wk combined resistance and endurance exercise program in patients with advanced non-small cell lung cancer (NSCLC) during in- and outpatient care.Methods In this intervention study, 40 patients with predominantly advanced NSCLC receiving simultaneous or sequential radiochemotherapy or chemotherapy alone were enrolled. For a period of 8 wk, patients were instructed to exercise at least five times per week during the inpatient setting and at least three times per week in the outpatient setting. Physical performance status (endurance capacity: 6-min walk test; strength capacity: handheld dynamometry), quality-of-life (Functional Assessment of Cancer Therapy-Lung), fatigue (Multidimensional Fatigue Inventory), and depression (Patient Health Questionnaire) were assessed at baseline (T0), after the exercise intervention (T1), and at a follow-up time point 8 wk later (T2). The primary end point was adequate adherence (feasibility) defined as completing at least two training sessions per week during a minimum of 6 wk.Results Of 40 patients, 31 (77.5%) completed the postexercise assessment (T1) and 22 (55%) completed follow-up (T2). The stages were IIA (5%), IIIA (8%), IIIB (20%), and IV (67%), and the median age was 63 yr (range = 22-75 yr). Overall, adherence was 82% for those patients who completed T1, and 55% of the 40 participating patients fulfilled the adequate adherence criterion. Those who completed the intervention showed a significant improvement in the 6-min walk distance and in knee, elbow, and hip muscle strength after the intervention (T1). Quality of life, fatigue, and depression scores remained stable or declined slightly. Significant improvements in knee-muscle strength were also observed at T2.Conclusions Exercise training is feasible in advanced and metastatic NSCLC patients during anticancer treatment. In this pilot study, endurance and strength capacity improved over time, indicating the rehabilitative importance of the applied intervention. To investigate the potential impact of exercise training in this patient group, a larger randomized trial is warranted.