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Morten Quist
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OA 11 - Reducing Burden: Patient-Centered Care (ID 682)
- Event: WCLC 2017
- Type: Oral
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:Beth Ivimey, E. Bernicker
- Coordinates: 10/18/2017, 11:00 - 12:30, Room 313 + 314
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OA 11.02 - Exercise Improves Functional Capacity in Patients with Advance Stage Lung Cancer (ID 10024)
11:10 - 11:20 | Presenting Author(s): Morten Quist
- Abstract
- Presentation
Background:
Identifying key issues for patients with lung cancer is central to assessing quality of life (QOL). Gralla el al described in 2014 a five rated issues which were: maintaining independence, ability to perform normal daily activities, ability to sleep, not being a burden for caregivers and not being fatigued. Studies have shown that patients with advanced lung cancer have a decline in functional capacity from diagnosed and during treatment. Studies examining physical exercise in patients with lung cancer have indicated increased physical capacity, functional capacity and muscular capacity, but no unambiguously significant improvements in QOL. The aim of this study is to investigate the effect of an exercise intervention for patients with advanced stage lung cancer.
Method:
Eligible patients >18 years with a WHO performance status 0-2 with stage IIIb-IV NSCLC and SCLC-ED who were undergoing chemotherapy at the Department of Oncology University Hospital Copenhagen were randomized to standard care or a 12 week physical and psycho-social intervention. Aerobic capacity (VO2peak), functional capacity (6MWD) and QOL (FACT-L) were measured at baseline and 12 weeks.
Result:
A total of 218 patients met the inclusion criteria and were randomized. There were no significant differences in baseline characteristics between the groups. There was a significant improvement in 6MWD in both groups, improvement in intervention was 41.1 m and improvement in control was 16.5 m. There were no significant differences between-groups in overal QOL (FACT-L) although there was a significant improvement in groups in overall QOL (FACT-L), Physical wellbeing, Emotrional wellbeing,Trial Outcome Index for the intervention group. There was a significant difference between groups in the subscale Social Wellbeing (FACT-L) P=<0.04.
Conclusion:
Conclusion: The results of this study demonstrate that functional capacity (6MWD) improves during a 12 week period for patients with advanced stage lung cancer. The improvements in both groups indicate an effect of chemotherapy on functional capacity however the significantly higher improvement in the intervention group indicate a further effect of the exercise intervention. The in-group improvement in QOL in the intervention group indicate a link between an incline in functional capacity and the QOL.
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P2.10 - Nursing/Palliative Care/Ethics (ID 711)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.10-003 - The Deterioration and Prognostic Value of Functional Capacity in Patients with Lung Cancer: A Systematic Review (ID 8769)
09:30 - 09:30 | Author(s): Morten Quist
- Abstract
Background:
Performance status (PS) scoring systems are of immense prognostic and clinical importance, however, the subjective evaluation of a patient’s global physical functioning is limited in sensitive prognostic stratification and existing literature present contradictory inter-rater reliability of PS assessments. The subjective assessment indicates the level of physical functioning, but does not provide a targeted treatment aim. Better treatment aims could be provided, if the level of decline in physical functioning was objectively collected and evaluated. To our knowledge, the significance of functional capacity in patients with lung cancer has never been evaluated prior to this review. Thus, the aim of this study was to identify and evaluate the evidence objectively examining 1) the decline in functional capacity in patients with lung cancer during cancer treatment, and 2) the prognostic value of functional capacity for patients with lung cancer.
Method:
The systematic review was reported according to PRISMA guidelines. A search in three databases: PubMed, EMBASE and Web of Science, generated 171 articles. Quantitative study designs, including case-series and case-controls, assessing functional capacity in patients with lung cancer were included. Self-reported functional capacity was excluded. No restrictions on publication date were imposed. Only articles published in English were considered for inclusion.
Result:
Eight studies on a total of 908 patients with lung cancer met the inclusion criteria. The majority of the studies were prospective cross-sectional studies (n=7), remaining was a case-control (n=1). Patients with lung cancer had already declined in functional capacity at baseline compared to healthy adults, and deteriorated further during initial cancer treatment. Functional capacity as a predictive measure was not associated with radiation induced lung injury. A 6-minute walking distance (6MWD) >400 m was associated with a 56 % reduction in the risk of death, and every 50 m improvement in 6MWD was associated with a 13 % risk reduction.
Conclusion:
The results of this review demonstrate that functional capacity (6MWD) declines following non-surgical NSCLC treatment as well as low functional capacity being associated with higher risk of mortality. By implementing an objective measure for functional capacity at the time of diagnosis, it could be possible to generate targeted treatment aims throughout the medical treatment and rehabilitation process. In addition, an objective measure for functional capacity could provide a better prognostic stratification.
