Feasibility of an eight‐week outpatient‐based pulmonary rehabilitation program for advanced lung cancer patients undergoing cytotoxic chemotherapy in Korea

Abstract

The scientific evidence supporting pulmonary rehabilitation (PR) for lung cancer patients undergoing cytotoxic chemotherapy is accumulating; however, the feasibility of outpatient‐based PR in these patients has not yet been evaluated in Korea. We conducted an eight‐week outpatient‐based PR feasibility study in a tertiary referral hospital setting. Patients with advanced lung cancer (non‐small cell lung cancer IIIB–IV and small‐cell lung cancer extensive disease) scheduled to undergo first‐line cytotoxic chemotherapy underwent PR consisting of 60‐minute sessions twice a week under the guidance and supervision of a physical therapist, for a total of eight weeks. Feasibility was assessed based on completion of the PR program. In total, 12 patients (median age 68 years) were enrolled; 11 (91.7%) were male with a history of smoking. Among these 12 patients, 9 (75%) completed the eight‐week outpatient‐based PR program. Three patients could not complete the PR program: two were unwilling and one died from complications of lung cancer. This study showed a 75% completion rate of an eight‐week outpatient‐based PR program for advanced lung cancer patients undergoing cytotoxic chemotherapy, which supports its feasibility.

Mobile Health Management Platform–Based Pulmonary Rehabilitation for Patients With Non–Small Cell Lung Cancer: Prospective Clinical Trial

“…Previous studies that reported the effects of PR in patients with lung cancer focused mostly on perioperative periods [10-17,23], whereas only a few studies assessed patients with advanced lung cancer [19,21,24,27,30]. In this study, we analyzed the effect of PR on both early- and advanced-stage lung cancer patients, and found improvements in exercise capacity (6MWD) and dyspnea, consistent with previous studies that reported improvements in exercise capacity [10-13,16,21,24,27] or dyspnea grade [21,27].…”

Feasibility of an outpatient‐based pulmonary rehabilitation program for lung cancer patients during radiation therapy

“…The factors contributing to poor adherence in previous studies included transportation problems, lack of motivation, work‐related reasons, hospitalization, aggravation of underlying disease, and very low exercise capacity 21,24,25 . One feasibility study of an outpatient‐based PR program for patients receiving chemotherapy reported a completion rate of 75%, in which accessibility and unwillingness were the reasons for refusing the PR program 12 . We observed a relatively higher completion rate than those in previous studies.…”

“…A review of studies on preoperative exercise training for patients with NSCLC concluded that exercise training before lung surgery improved exercise capacity and forced vital capacity (FVC) 9 . However, there are few reports of PR programs in lung cancer patients treated with chemotherapy or radiation therapy 10–15 …”

“…9 However, there are few reports of PR programs in lung cancer patients treated with chemotherapy or radiation therapy. [10][11][12][13][14][15] While radiation therapy is an important treatment modality for lung cancer, it can cause radiation-induced lung injury (RILI), including pneumonitis or radiationinduced pulmonary fibrosis (RIPF), and pneumonia, and pulmonary function declines after radiation therapy. 16,17 Although there are not many studies regarding PR programs in patients with lung cancer receiving radiation therapy, some studies have shown that PR programs may be beneficial to lung cancer patients undergoing radiation therapy.…”

“… 9 However, there are few reports of PR programs in lung cancer patients treated with chemotherapy or radiation therapy. 10 , 11 , 12 , 13 , 14 , 15 …”