PRELIMINARY DATA OF AN EARLY PULMONARY
REHABILITATION PROGRAMME IN SURGICALLY
TREATED LUNG CANCER PATIENTS.
Mainini C, Bardelli R, Kopliku B, Sobral Rebelo PF, Cantarelli L, Tenconi S, Rapicetta C, Piro R, Costi S, Galeone C, Ruggiero P, Tedeschi C, Fugazzaro S
IRCCSArcispedale Santa Maria Nuova – Istituto di Ricovero e cura a Carattere Scientifico, Reggio Emilia (Italy)
Introduction
Results
Materials and Methods
Conclusions
References
Preliminary data suggest that PUREAIR program is feasible and promising for patients with lung cancer.
Crandall K, Maguire R, Campbell A, et al. Exercise intervention for patients surgically treated for Non-Small Cell Lung Cancer (NSCLC): a systematic review. Surg Oncol 2014; 23(1): 17–30; Cavalheri V, Tahirah F, Nonoyama M, et al. Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database Syst Rev 2013; 7: CD009955.; Mainini C, Rebelo PF, Bardelli R, Kopliku B, Tenconi S, Costi S, Tedeschi C, Fugazzaro S. Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence? SAGE Open Med. 2016 Oct 19;4:2050312116673855.
Until now we enrolled 79 patients, 40 in IG and 39 in CG. Seventy-two patients completed T1 evaluation; 31 completed T3.
Preliminay data show that:
- patients’ compliance to the program is high preoperative programme (n=34) 97 % to outpatient and 82% to home based sessions; postoperative program (n=18) 98% to outpatient and 89% to home based sessions.
- in IG there is a significant improvement in 6MWT after pre-operative PR, and this improvement is still present 6 months after surgery. Concerning pulmonary function, there is a difference in FVC after pre-operative PR in IG and a significative worsening in FEV1 6 months after surgery in CG. At baseline there were no difference between groups.
Comparison T0-T1 in IG for exercise capacity and pulmonary function (Tab.3).
Non-small cell lung cancer is the most common type of lung cancer. Surgery appears to be the most effective treatment in early stage although it has important impact on quality of life. Pulmonary rehabilitation (PR), both before and after surgery, could reduce symptoms and morbidity and improve exercise capacity, pulmonary function and quality of life.
Aim. Assess the efficacy of a pre and post-operative
PR programme (PUREAIR) for lung cancer patients on exercise capacity and quality of life.
Three-years open-label RCT.
Participants: suspected/diagnosed primary lung
cancer eligible for surgery, staging staging I-II, not candidates for neoadiuvant/adiuvant therapy.
Standard care (CG): one therapeutic educational
session the day before surgery and early standard inpatient PR after surgery.
Intervention group (IG): standard care +
preoperative PR (6 outpatients sessions and 8 home based) + post-operative PR (15 outpatients sessions and 24 home based). This experimental treatment is based on aerobic, resistance and respiratory training both pre and post-operative.
Assessments: T0: baseline; T1: the day before
surgery; T2 one month after surgery; T3: six months after surgery (Tab.1)
* Complication, at T1 refered to inpatients period;
Tab.3 T0 T1 p- value 6MWT m (mean±SD) 448.0±69,5 473.0±83.2 0.003 FEV1(%) (mean±SD) ±24.895.9 ±22.893,8 0.507 FVC(%) (mean±SD) 109.0±24,0 ±25,2116 0.004
Comparison T0-T3 in IG and CG (Tab.4).
Tab.1 T0 R A N D O M I S A T I O N T1 T2 T3 IG CG IG CG IG CG 6MWT X X X X X X PFT X X X X X C* X X X X X X SF-12 X X X HADS X X X X X NRS X X X X X Tab.4 T0 T3 p-value 6MWT m (mean±SD) IG 457,0 ± 73,5 ±80,9513,0 0,002 CG 424,0±68,9 ±102,0429,0 0,809 FEV1 (%) (mean±SD) IG ±26,195,8 ±20,990,7 0,090 CG ±17,592,3 ±18,585,5 0,047 FVC (%) (mean±SD) IG 107,0±25,5 ±15,9108,0 0,795 CG 104,0±21,8 ±22,697,3 0,102
SERVIZIO SANITARIO REGIONALE
EMILIA-ROMAGNA
Azienda Ospedaliera di Reggio Emilia
Arcispedale S. Maria Nuova
Istituto in tecnologie avanzate e modelli assistenziali in oncologia Istituto di Ricovero e Cura a Carattere Scientifico
This research was supported by Italian Ministry of Health, that we would like to thank very much for funding the project ”Effects of early pulmonary rehabilitation and long-term
exercise on lung function, quality of life and postoperative outcome in lung cancer patients.” (Project Code : GR-2011-02351711), within Bando Ricerca Finalizzata e Giovani
Ricercatori 2011/2012.
Drop-out IG CG
Lost to follw-up 4 1
Excluded tor adiuvant therapy 2 6
