The Utility of Exercise Testing in Patients with Lung Cancer.
The Utility of Exercise Testing in Patients with Lung Cancer.
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DOI：
10.1016/j.jtho.2016.04.021
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Fuster M
中科院分区：
文献类型：
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作者：
Ha D;Mazzone PJ;Ries AL;Malhotra A;Fuster M
与肺癌治疗相关的危害包括围手术期发病率和死亡率以及各种器官（包括心脏和肺）中的治疗诱导毒性。因此，最佳治疗需要进行风险评估，以权衡受益与伤害的可能性。运动测试提供了客观评估患者身体健康/运动能力的机会。在肺癌中，它最常用于对接受肺癌切除术评估的患者进行风险分层。近年来，它在此背景下的使用已被描述，包括非手术候选人和肺癌幸存者。在这篇文章中，我们回顾了运动试验和肺癌的生理学。然后，我们在四种情况下评估运动试验在肺癌患者中的效用（肺癌切除术前评估、肺癌切除术后、肺癌预后和运动训练计划的有效性评估）在系统地识别涉及该患者人群中最常见形式的运动试验的原始研究后：实验室心肺运动试验和简单的现场试验，包括6分钟步行试验、穿梭步行试验和/或爬楼梯试验。最后，我们提出了一个概念性的框架，风险评估的肺癌患者正在考虑治疗，并确定在这一患者人群的进一步研究领域。
The harm associated with lung cancer treatment include perioperative morbidity and mortality and therapy-induced toxicities in various organs, including the heart and lungs. Optimal treatment therefore entails a need for risk assessment to weigh the probabilities of benefits versus harm. Exercise testing offers an opportunity to evaluate a patient’s physical fitness/exercise capacity objectively. In lung cancer, it is most often used to risk-stratify patients undergoing evaluation for lung cancer resection. In recent years, its use outside this context has been described, including in nonsurgical candidates and lung cancer survivors. In this article we review the physiology of exercise testing and lung cancer. Then, we assess the utility of exercise testing in patients with lung cancer in four contexts (preoperative evaluation for lung cancer resection, after lung cancer resection, lung cancer prognosis, and assessment of efficiency of exercise training programs) after systematically identifying original studies involving the most common forms of exercise tests in this patient population: laboratory cardiopulmonary exercise testing and simple field testing with the 6-minute walk test, shuttle walk test, and/or stair-climbing test. Lastly, we propose a conceptual framework for risk assessment of patients with lung cancer who are being considered for therapy and identify areas for further studies in this patient population.