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Exercise Improves Lung Surgery Outcome

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Lung surgery is one of most invasive types of surgery a patient can undergo, and is followed by lengthy, difficult recovery periods. A study published at the June 2008 ASCO Conference shows that the overall outcome of surgery (Cardiorespiratory Fitness and Quality of Life) for lung cancer patients is significantly improved when patients undergo post-surgical aerobic exercise training:

Abstract: Effect of aerobic exercise training on cardiorespiratory fitness and quality of life in postsurgical non-small cell lung cancer patients. Sub-category: Adjuvant Therapy. Category: Lung Cancer--Local-Regional and Adjuvant Therapy. Meeting: 2008 ASCO Annual Meeting. Abstract No: 7577. Citation: J Clin Oncol 26: 2008 (May 20 suppl; abstr 7577). Author(s): L. Jones, J. Garst, N. Eves, M. West, S. Mabe, J. Crawford

Background: The effects of standard NSCLC adjuvant therapy (i.e., pulmonary resection, adjuvant chemotherapy) together with deconditioning secondary to treatment has a profound negative impact on patients functional capacity leading to increased susceptibility to other common age-related diseases, poor quality of life, and likely premature death. Accordingly, we conducted a feasibility study examining the effects of an aerobic exercise training program on cardiorespiratory fitness and QOL among newly diagnosed postsurgical NSCLC patients.

Methods: Using a single-group design, 20 patients with newly diagnosed, histologically confirmed stage I-IIIA NSCLC who had undergone complete surgical resection were recruited. Exercise training consisted of three endurance cycle ergometry sessions per week at 60% to 100% of baseline peak oxygen consumption (VO2peak) for 14 weeks. VO2peak was assessed using a maximal, incremental, cardiopulmonary exercise test with expired gas analysis. Overall QOL and fatigue was assessed by the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale.

Results: Nineteen patients completed the study and overall adherence rate was 82% (range: 28% - 100%). Intention-to-treat analysis indicated that VO2peak increased 1.1 mL.kg.min-1 (95% CI, -0.2 to 2.5; p=0.095) whereas FACT-L increased 10.6 points (95% CI, -1.0 to 22.2; p=0.071) and fatigue decreased 6.9 points (95% CI, 1.0 to 12.8; p=0.026) from baseline to postintervention. Per protocol analysis indicated that patients who attended >80% exercise sessions (n=13) increased 1.7 mL.kg.min-1 (95% CI, 0.2 to 3.1; p=0.028) whereas FACT-L increased 13 points (95% CI, -1.9 to 28.2; p=0.081) and fatigue decreased 7.7 points (95% CI, 0.3 to 15.1; p=0.042). Linear regression analysis indicated that change in VO2peak was associated with total exercise volume (r=0.54, p=0.016) but not exercise adherence (r=0.38, p=0.105).

Conclusions: Postoperative aerobic exercise training is feasible and associated with significant improvements in VO2peak, QOL, and fatigue in NSCLC patients, particularly if acceptable adherence is achieved. This benefit may have important implications for post-operative recovery and survivorship in operable NSCLC patients.

Source: http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts&vmview=abst_detail_view&confID=55&abstractID=32348

Submitted by Carole

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