Abstract
Preoperative fitness is best assessed with cardio-pulmonary exercise testing (CPET) in patients with non-small cell lung cancer (NSCLC). Peak Oxygen consumption (VO2 peak) is predictive of short-term complications after thoracic surgery. Feasibility and effect of short-term (2 to 3 weeks) rehabilitation on fitness and short-term outcomes are unknown.
We planned a pragmatic, randomized controlled trial (RCT) comparing short-term rehabilitation (R) with usual care (UC) in patients with operable NSCLC.
Method: This ongoing study enrolls patients after baseline CPET from 2 centres in Switzerland. Intervention: preoperative three-times a week, intensive, respiratory physiotherapist supervised interval training. Controls: usual care
Outcomes: post-operative complication rate, short-term change in VO2 (baseline and immediately before surgery), long-term fitness and quality of life.
Results: Up to december 2011, 65 patients were randomized, R n=31, UC n=34 (mean age 63.4 [10.5], FEV1 86.7% [23.5], DLCO 70.5% [19.0], VO2 peak 19.5 ml/min/kg [5.7] watt peak 86 W[38], 6MWT 370 m [101]). As reassessed immediately before surgery VO2 peak (+2.3 [0.7] ml/min/kg, p=0.04), watt (+15.5 [4.6] W, p=0.04), 6MWT (+87 [15.5] m, p<0.01) improved in R but not in UC patients.
Conclusion: This interim analysis shows that short-term intensive rehabilitation is feasible and improves fitness before surgery in patients with resectable NSCLC.
- © 2012 ERS
