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Kristina Poulsen



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    OA04 - Improving Access and Outcomes in Lung Cancer Management (ID 898)

    • Event: WCLC 2018
    • Type: Oral Abstract Session
    • Track: Nursing and Allied Professionals
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 10:30 - 12:00, Room 201 F
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      OA04.07 - Early Initiated Postoperative Rehabilitation Reduces Fatigue in Patients with Operable Lung Cancer: A Randomized Trial (ID 13733)

      11:35 - 11:45  |  Author(s): Kristina Poulsen

      • Abstract
      • Presentation
      • Slides

      Background

      Surgical tolerability and perioperative risk of complications are correlated with high age, smoking history, comorbidities, low cardiorespiratory fitness (VO2peak) and low functional capacity, which paradoxically are characteristics describing the average patient with lung cancer. Little is known about the optimal amount and timing of exercise strain in concern of the operation wound and with regard improvement of physical function and quality of life (QOL). On this background, we decided to investigate the effect of early vs. late initiated postoperative rehabilitation in patients with operable lung cancer on exercise capacity, functional capacity, muscle strength, and QOL.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The study was designed as a two-armed randomized controlled trial with randomization to either early initiated postoperative rehabilitation (14 days after surgery (ERG)) or a control arm with late initiated postoperative rehabilitation (14 weeks after surgery (LRG)). The primary endpoint was a change in maximum oxygen consumption (VO2peak) from baseline to post intervention 26 weeks following lung resection. Fatigue was measured with EORTC QLQ C30 LC13.

      4c3880bb027f159e801041b1021e88e8 Result

      From April 2013 to June 2016, 582 patients with operable NSCLC were screened for eligibility. With 119 patients randomized in the early rehabilitation group (ERG) (68 females, 51 males; median age 65), and 116 randomized to late rehabilitation group (LRG) (62 females, 54 males; median age 65) the recruitment rate was 52.6%. There was a non-significant decrease in VO2peak in both ERG and LRG from baseline to 26 weeks and no significant difference between ERG and LRG (p=0.9269). There was a significant decrease from baseline to 14 weeks in both ERG (p=0.027) and LRG (p<0.001) and a significant difference between groups (p=0.0018). There was a non-significant increase from 14 weeks to 26 weeks in ERG (p=0.464) and a significant increase from 14 weeks to 26 weeks in LRG (p<0.001) and a significant difference between the two groups (p=0.0003). We found no significant differences in QOL but we found a significant difference between ERG and LRG from baseline to 14 weeks in fatigue level in favour of ERG.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This is the first randomized controlled trial to investigate the effects of early vs. late initiated postoperative rehabilitation in patients with lung cancer. There is no difference in the commencement (early vs. late) of a postoperative exercise program for patients with lung cancer on exercise capacity. But to reduce fatigue patients should be recommended to initiate early exercise programs.

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