Prädiktoren und Outcome stationärer Rehabilitation bei Patienten mit Bronchialkarzinom

Abstract

BACKGROUND: There are no data on the efficacy of in-patient rehabilitation after surgery and/or radiation and/or chemotherapy against lung cancer. The purpose of this prospective study was to assess changes in exercise capacity, lung function and quality of life (QoL) before and after an inhouse training programme. METHODS: 45 patients with lung cancer (WHO I-III after surgery and/or radiation and/or chemotherapy treatment) entered a 28-day in house rehabilitation programme including of standardized aerobic training (submaximal interval training on bicycle ergometer daily, 6 times a week, 30 min., heart-rate-adjusted). Functional status and the health-related quality of life (QLQ-C30, QLQ-LC13, SF-36 and MFI-20) were examined at the beginning, within the rehab stay and at day 28. RESULTS: A substantial increase of work performance (bicycle ergometry from 68 ± 3 to 86 ± 4 Watt and six-minute walking test from 322 ± 11 to 385 ± 13 meter) could be noticed. Pulmonary function (FEV1 from 70 ± 3 to 73 ± 3, also FVC from 77 ± 3 to 82 ± 3 %) rose significantly. Also, heart rates at rest could be reduced (from 84 ± 2 to 80 ± 1 beat per miniute) and the heart rate variability (measure of efficacy of endurance training) could be raised significantly (9,7 ± 1 to 12,9 ± 1 root mean square of successive differences). Moreover, health-related quality of life significantly improved (48 ± 3 to 62 ± 2) and fatigue declined from 66 ± 3 to 41 ± 4. In addition, there were no age- or gender-dependent correlations with physical performance, quality of life and the extent of fatigue. Good motivation however, was found to be a predictor for a high rehabilitation outcome. CONCLUSIONS: Standardized aerobic endurance training improves physiological and psychological parameters after surgery and/or radiation and/or chemotherapy for lung cancer. A future trial will compare this programme against a control group (no rehabilitation programme) over a 6-month period to verify a longerlasting effect of lung cancer rehabilitation.