Effects of curative-intent lung cancer therapy on functional exercise capacity and patient-reported outcomes
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ORIGINAL ARTICLE
Effects of curative-intent lung cancer therapy on functional exercise capacity and patient-reported outcomes Duc Ha 1,2,3
&
Andrew L. Ries 3 & Scott M. Lippman 3,4 & Mark M. Fuster 5,3
Received: 6 September 2019 / Accepted: 3 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Lung cancer treatment can lead to negative health consequences. We analyzed the effects of curative-intent lung cancer treatment on functional exercise capacity (EC) and patient-reported outcomes (PROs). Methods We performed a prospective, observational cohort study of consecutive patients with stage I–IIIA lung cancer undergoing curative-intent therapy and assessed functional EC (primary outcome, six-minute walk distance (6MWD)), cancer-specific quality of life (QoL) (secondary outcome, European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC-QLQ-C30) summary score), and exploratory outcomes including dyspnea (University of California San Diego Shortness of Breath Questionnaire (UCSD SOBQ)) and fatigue Brief Fatigue Inventory (BFI)) symptoms before and at 1 to 3 months posttreatment. We analyzed the time effect of treatment on outcomes using multivariable generalized estimating equations. Results In 35 enrolled participants, treatment was associated with a clinically meaningful and borderline-significant decline in functional EC ((mean change, 95% CI) 6MWD = − 25.4 m (− 55.3, + 4.47), p = 0.10), clinically meaningful and statistically significant higher dyspnea (UCSD SOBQ = + 13.1 (+ 5.7, + 20.6), p = 0.001) and fatigue (BFI = + 10.0 (+ 2.9, + 17.0), p = 0.006), but no clinically meaningful or statistically significant change in cancer-specific QoL (EORTC-QLQ-C30 summary score = − 3.4 (− 9.8, + 3.0), p = 0.30). Conclusions Among the first prospective analysis of the effect of curative-intent lung cancer treatment on functional EC and PROs, we observed worsening dyspnea and fatigue, and possibly a decline in functional EC but not cancer-specific QoL at 1 to 3 months post-treatment. Interventions to reduce treatment-related morbidities and improve lung cancer survivorship may need to focus on reducing dyspnea, fatigue, and/or improving functional EC. Keywords Treatment outcome . Patient-reported outcome measures . Symptom assessment . Quality of life . Survivorship
Abbreviations 6MWD 6MWT
Six-minute walk distance Six-minute walk test
AECOPD BFI CTB
Acute exacerbation of COPD Brief Fatigue Inventory Chest tumor board
The contents of this manuscript were previously made available in a preprint publication (https://doi.org/10.1101/508234), revised, and updated in this current version. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05294-3) contains supplementary material, which is available to authorized users. * Duc Ha [email protected]; [email protected] 1
2
Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd Suite 200, Aurora, CO 80014, USA Pulmonary, Critical Care,
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