This prospective observational study aimed to explore the influence of physical inactivity during initial chemotherapy on the risk of disability and hospitalization in later life among older patients with advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Patients aged 70 or above who were scheduled to receive first-line chemotherapy for newly diagnosed advanced NSCLC were recruited for the study. An electronic pedometer was used to measure daily steps; based on the change rate (cutoff: −12.5%) from pretreatment to 12 ± 4 weeks after enrolment, patients were classified as active or inactive. The Barthel Index estimated activities of daily living. We compared disabilityfree survival time, mean cumulative functions of hospital stays, and medical costs, between the active and inactive groups. Results: Among the 29 patients enrolled, 21 were evaluable. Compared with active patients (n = 11), inactive patients (n = 10) showed shorter disability-free survival (6.4 vs 19.9 months, p < 0.05) and tended to have longer hospital stays (23.7 vs 6.3 days/person) and higher inpatient care cost (¥1.6 vs ¥0.3 million/person [US$16,000 vs US$3000/person]) during the first year. Conclusion: Physical inactivity during initial chemotherapy may be a risk factor for developing disability and requiring hospitalization in later life for older patients with advanced NSCLC. Our findings may indicate the need for lifestyle interventions with multidisciplinary teams, which include physicians, nurses, and physiotherapists, for older patients with advanced lung cancer during an active cancer treatment. A large-sample-sized study is needed to validate our findings.
Purpose: To investigate the informative aspects of eating rate in hematopoietic stem cell transplantation(HSCT)using the patients' nutritional pathway. Methods: Patients who underwent HSCT and followed the patients' nutritional pathway in the Division of Stem Cell Transplantation at Shizuoka Cancer Center between Jane 2019 and Dec 2019 were evaluated from pre-treatment to the end of parenteral nutrition(PN) . Eating rate, caloric intake(kcal/ideal body weight [IBW]kg/day) , the PN period, and the relationships between nutrition-related adverse events over time and between eating rate and caloric intake were investigated. Results: Median age of the 10 cases(3 women)was 56 years(range, 32-70 years)and median body mass index was 22.1 kg/m 2 (18.2-25.8 kg/m 2 ) . Median eating rate during the period was 61.3% (34.0-90.9%) , caloric intake was 11 kcal/IBW kg/day (7-22 kcal/IBW kg/day) , and the PN period was 33 days (15-60 days) . Eating rate was correlated with caloric intake and the PN period. (r=0.75, P=0.012; r=-0.65, P=0.044) . Nutritional-related adverse events over time, eating rate, and caloric intake showed negative correlations(eating rate: r=-0.57, P<0.001; caloric intake: r=-0.62, P<0.001) . Conclusion: Eating rate in allogeneic HSCT using the patients' nutritional pathway can be informative, and thus beneficial for treatment. (Journal of Hematopoietic Cell Transplantation 9 (3) : 83-92, 2020.
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