Quist Morten, Langer Seppo W, Lillelund Christian, Winther Lærke, Laursen Jørgen H, Christensen Karl B, Rørth Mikael, Adamsen Lis
University Hospitals Centre for Health Research Department, Rigshospitalet, University of Copenhagen, 9701 Denmark.
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
Lung Cancer. 2020 Jul;145:76-82. doi: 10.1016/j.lungcan.2020.05.003. Epub 2020 May 8.
Exercise can improve treatment-related side effects, quality of life, and function in patients with various types of cancer; however, more evidence is needed for patients with advanced inoperable lung cancer.
We randomized 218 patients with advanced inoperable lung cancer to a 12-week supervised, structured exercise training program (aerobic, strength, and relaxation training) twice weekly versus usual care. Primary outcome was change in maximal oxygen uptake (VO peak). Secondary outcomes were muscle strength, functional capacity, forced expiratory volume in 1 s, health-related quality of life, anxiety, and depression.
There was no significant difference between the intervention and control groups in VO peak. There was a significant improvement in muscle strength. There was also a significant difference between the two for social well-being (Functional Assessment of Cancer Therapy-Lung, FACT-L), anxiety, and depression.
There was a significant reduction in the level of anxiety and depression and a significant increase in all muscle strength outcomes in the intervention group compared to patients randomized to usual care. There was a significant difference between the groups for social well-being. The primary outcome did not show a significant improvement in VO peak. Based on our results, future patients with advanced inoperable lung cancer should be considered for supervised exercise during the course of their disease.
运动可改善各类癌症患者与治疗相关的副作用、生活质量及功能；然而，对于晚期无法手术的肺癌患者，还需要更多证据。
我们将218例晚期无法手术的肺癌患者随机分为两组，一组接受为期12周、每周两次的有监督的结构化运动训练项目（有氧运动、力量训练和放松训练），另一组接受常规护理。主要结局指标是最大摄氧量（VO₂峰值）的变化。次要结局指标包括肌肉力量、功能能力、第1秒用力呼气量、健康相关生活质量、焦虑和抑郁。
干预组和对照组在VO₂峰值上无显著差异。肌肉力量有显著改善。两组在社会幸福感（肺癌治疗功能评估量表，FACT-L）、焦虑和抑郁方面也存在显著差异。
与随机接受常规护理的患者相比，干预组的焦虑和抑郁水平显著降低，所有肌肉力量指标均显著提高。两组在社会幸福感方面存在显著差异。主要结局指标在VO₂峰值上未显示出显著改善。基于我们的研究结果，未来晚期无法手术的肺癌患者在病程中应考虑接受有监督的运动。
