Impairments after curative intent treatment for non-small cell lung cancer: a comparison with age and gender-matched healthy controls.
BACKGROUND
The aim of this study was to compare measures of exercise capacity, health-related quality of life (HRQoL), muscle force, lung function and feelings of anxiety and depression in people after curative intent treatment for NSCLC with age and gender-matched healthy controls.


METHODS
This cross-sectional study included 23 participants (68 ± 10yr; 16 females), 6-10 weeks after lobectomy for NSCLC or, for those who received adjuvant chemotherapy, 4-8 weeks after their last cycle. The study also included 20 age and gender-matched healthy controls (69 ± 5yr; 13 females). All participants underwent measurements of exercise capacity (cycle-ergometry test [CPET] and 6-min walk test [6MWT]), HRQoL (Short-Form 36 general health survey [SF-36]), handgrip force, quadriceps torque, lung function and feelings of anxiety and depression.


RESULTS
When compared with data collected in healthy controls, those in the NSCLC group demonstrated impairments in the peak rate of oxygen consumption (15 ± 3 versus 24 ± 7 ml kg(-1)·min(-1); p < 0.001) and maximum work rate (75 ± 25 versus 127 ± 51Watts; p < 0.001) measured during the CPET, and 6-min walk distance (494 ± 77 versus 649 ± 61 m; p < 0.001). Similarly, impairments were demonstrated in all domains of the SF-36 (p < 0.01 for all), isometric handgrip force (28 ± 7 versus 34 ± 10 kg; p = 0.02), and all measures of lung function (p ≤ 0.001 for all). A higher score for depression was also seen (3.0 ± 2.5 versus 1.5 ± 1.6; p = 0.03). There was no difference between the groups in isometric quadriceps torque or feelings of anxiety.


CONCLUSIONS
After curative intent treatment for NSCLC, compared to healthy controls, impairments were demonstrated in laboratory and field-based measures of exercise capacity, HRQoL, isometric handgrip force and lung function. Although people after curative intent treatment for NSCLC reported greater feelings of depression, these levels were below those considered clinically relevant. These findings suggest that people after curative intent treatment for NSCLC may benefit from rehabilitative strategies to optimise exercise capacity and HRQoL.
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia. Electronic address: vinicius.cavalher@curtin.edu.au.
Vinicius
V
Cavalheri
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia, Hospital Avenue, Nedlands, WA 6009, Australia. Electronic address: s.jenkins@curtin.edu.au.
Sue
S
Jenkins
Institute for Respiratory Health, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia, Hospital Avenue, Nedlands, WA 6009, Australia; Community Physiotherapy Services, 151 Wellington Street, Perth, WA 6000, Australia. Electronic address: nola.cecins@health.wa.gov.au.
Nola
N
Cecins
Department of Respiratory Medicine, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia; School of Medicine and Pharmacology, University of Western Australia, GPO Box X2213 Perth, WA 6847, Australia. Electronic address: kevin.gain@health.wa.gov.au.
Kevin
K
Gain
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia. Electronic address: martin.phillips@health.wa.gov.au.
Martin
M
Phillips
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia. Electronic address: lucas.sanders@health.wa.gov.au.
Lucas H
LH
Sanders
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Physiotherapy Department, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia. Electronic address: K.Hill@curtin.edu.au.
Kylie
K
Hill
D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D011788:Quality of Life; D012737:Sex Factors; D016138:Walking / Q000502:physiology
Carcinoma; Exercise capacity; Non-small cell; Surgery