Abstract
Clinical intervention studies support the efficacy and safety of exercise programs as a treatment modality for non-small-cell lung cancer (NSCLC) during adjuvant/palliative treatment, but the effectiveness of real-world oncogeriatric services is yet to be established. We aimed to examine the effects of a 10-week structured and individualized multicomponent exercise program on physical/cognitive functioning and mental wellness in elderly patients with NSCLC under adjuvant therapy or palliative treatment. A non-randomized, opportunistic control, longitudinal-design trial was conducted on 26 patients with NSCLC stage I–IV. Of 34 eligible participants, 21 were allocated into two groups: (i) control group (n = 7) received usual medical care; and (ii) intervention group (n =19) received multicomponent program sessions, including endurance, strength, balance, coordination and stretching exercises. Tests included the Short Physical Performance Battery (SPPB), 5-m habitual Gait Velocity Test (GVT), Timed Up & Go Test (TUG), 6-Min Walk Test (6MWT), independence of activities in daily living (IADL), muscular performance, cognitive function, and quality of life, which were measured at baseline and after 10 weeks of the program. Results revealed a significant group×time interaction for SPPB (p = 0.004), 5-m GVT (p = 0.036), TUG (p = 0.007), and muscular performance (chest and leg power; p < 0.001). Similarly, significant changes were observed between groups for cognitive functioning (p = 0.021) and quality of life for EUROQoL 5D (p = 0.006). Our findings confirm that a multicomponent exercise program improves measures of physical/cognitive functioning and quality of life in the elderly with NSCLC under adjuvant therapy or palliative treatment. This is an interesting and important study that adds to our current body of knowledge on the safety of exercise interventions, especially in the elderly with solid tumors.
Highlights
Lung cancer remains a leading cause of mortality worldwide among men and women, with 2.1 million new lung cancer cases and 1.8 million deaths predicted in 2018, representing almost 1 in 5 cancer deaths (18.4%) [1]
All of these features have a likely effect on physical function/performance and will have a negative impact on health-related quality of life (HRQoL), functional status, and the ability to participate in activities of daily living (ADLs) [6]
Our findings confirm our hypothesis that a multicomponent exercise program in the elderly with non-small-cell lung cancer (NSCLC) under adjuvant therapy or palliative treatment positively affects measures of functional capacity measured by Short Physical Performance Battery (SPPB), Gait Velocity Test (GVT), and muscular performance (1RM and power)
Summary
Lung cancer remains a leading cause of mortality worldwide among men and women, with 2.1 million new lung cancer cases and 1.8 million deaths predicted in 2018, representing almost 1 in 5 cancer deaths (18.4%) [1]. People aged 75 and over already represent around one third of cancer patients, and incidence rates are increasing with age for most tumors [4,5,6]. All of these features have a likely effect on physical function/performance and will have a negative impact on health-related quality of life (HRQoL), functional status, and the ability to participate in activities of daily living (ADLs) [6]. Improving psychosocial well-being to enhance HRQoL and physical function is a primary goal at all stages of lung cancer during treatment and survivorship [7]
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