Physical activity in inoperable lung cancer

Abstract

Background: Guidelines provide physical activity (PA) recommendations in cancer, yet in inoperable lung cancer evidence is limited regarding associations between PA levels and other outcomes. Aims: 1) to analyse PA of participants recruited to an RCT in the six months after commencing treatment; and in the usual care (UC) group only to 2) explore whether baseline PA levels were predictive of improved physical function and patient-reported outcomes at six-months and 3) identify baseline participant characteristics associated with higher PA levels at six months. Method: assessor-blinded RCT. The intervention (IG) comprised eight weeks of exercise, behaviour change and symptom management. Outcomes, assessed at baseline, nine weeks and six months, included PA (7 days of accelerometry), six-minute walk distance, muscle strength, symptoms and health-related quality of life (HRQoL). Results: 92 participants were randomised (45 IG, 47 UC). 80 completed baseline accelerometry (39 IG, 41 UC), characteristics: mean(SD) age 63.0 (12.3) years, 56% male, 51% stage IV disease. Baseline PA levels: median (IQR) steps/day 2859.6 (2034.0-3849.2) IG versus 3195.2 (2161.2-4839.0) UC. Lower baseline PA was associated with cachexia (p=0.06). Between-group change score (steps/day) mean differences (95% CI) at nine weeks (174.5 (-1504.7 to 1853.7), p=0.84) and six months (574.0 (-1162.3 to 2310.3), p=0.52). Associations between UC baseline daily steps and outcomes at six months were weak and only significant for HRQoL (rho=0.41, p=0.03). UC daily steps (n=27) at six months were significantly associated with age (rho=-0.44, p=0.02). Conclusion: further research is required to determine which patient subgroups may derive the greatest benefits from PA intervention.