Exercise is beneficial for various cancer populations. However, there is limited evidence regarding inoperable lung cancer patients with advanced or metastatic disease. Thus, we assessed in this population the impact of an extended care intervention with or without an exercise program, on fatigue, quality of life and physical fitness.
We randomly assigned 227 patients with advanced or metastatic lung cancer within 3 months after primary diagnosis to an experimental group (EX+) and a control group (CON). EX+ received a 24-week partly-supervised combined resistance and aerobic training 3x/week and weekly care management phone calls (CMPC). CON received CMPC alone. Primary endpoints were physical well-being and general fatigue at week 12 assessed by the Functional Assessment for Cancer Therapy - Lung (FACT-L) questionnaire and the Multidimensional Fatigue Inventory. Secondary endpoints comprised quality of life outcomes, psychological distress and physical performance. Analysis of covariance models were conducted regarding changes from baseline to week 12.
No significant effects on the primary endpoints were observed. Intent-to-treat analyses showed significant between group differences for knee extensor muscle strength favoring EX+ (p=.04). Subgroup analyses revealed that EX+ patients with good training adherence, i.e. regularly participating in supervised exercise sessions with adherence rates >70% (n=46), achieved significant benefits with respect to general fatigue (p=.01), functional well-being (p=.03) and the Trial Outcome Index of the FACT-L (p=.04).
Inoperable lung cancer patients might not benefit from additional exercise programs beyond an extended care intervention during palliative treatment. However, among patients with good adherence, training may have favorable effects.
Clinical trial identification