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疑似局部晚期和转移性肺癌的早期康复治疗。

Early prehabilitation in suspected locally advanced and metastatic lung cancer.

机构信息

Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK

Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK.

出版信息

BMJ Support Palliat Care. 2024 Jan 8;13(e3):e908-e911. doi: 10.1136/spcare-2023-004349.

Abstract

OBJECTIVES

The most common treatment for locally advanced and metastatic lung cancer is best supportive care. Patients with lung cancer are often comorbid with a high symptom burden. We wanted to assess whether early prehabilitation was feasible in patients with likely lung cancer.

METHODS

Patients were offered prehabilitation if they were attending the new patient respiratory clinic, had a CT scan suggesting stage III or IV lung cancer and undergoing further investigations. Patients receiving palliative care were ineligible. All prehabilitation patients were referred to a palliative medicine physician, registered dietitian and rehabilitation physiotherapist.

RESULTS

50 patients underwent prehabilitation between June 2021 and August 2022. The median age was 72 years (range 54-89 years). 48 patients had lung cancer. 84% of patients attended all three interventions.Half of the palliative care consultations focused on pain. Half of the patients seen had a change in medication. 25% of patients' weights were stable, 32% required a food-first strategy and 33% required oral nutritional supplements. 57% of patients discussed managing breathlessness with the physiotherapist.

CONCLUSIONS

Early prehabilitation is feasible alongside the investigation of locally advanced and metastatic lung cancer. Further work will aim to assess its impact on admission to the hospital, survival and treatment rates.

摘要

目的

局部晚期和转移性肺癌的最常见治疗方法是最佳支持治疗。患有肺癌的患者通常伴有较高的症状负担。我们想评估早期预康复在可能患有肺癌的患者中是否可行。

方法

如果患者正在新患者呼吸诊所就诊、CT 扫描提示 III 期或 IV 期肺癌且正在接受进一步检查,则为其提供预康复。接受姑息治疗的患者不符合条件。所有预康复患者都被转介给姑息医学医生、注册营养师和康复理疗师。

结果

2021 年 6 月至 2022 年 8 月期间,50 名患者接受了预康复。中位年龄为 72 岁(54-89 岁)。48 名患者患有肺癌。84%的患者参加了所有三项干预措施。一半的姑息治疗咨询重点是疼痛。一半的患者的药物发生了变化。25%的患者体重稳定,32%需要以食物为主的策略,33%需要口服营养补充剂。57%的患者与理疗师讨论了管理呼吸困难的问题。

结论

局部晚期和转移性肺癌的同时进行早期预康复是可行的。进一步的工作将旨在评估其对住院、生存和治疗率的影响。

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