The impact of physical activity on fatigue and quality of life in lung cancer patients: a randomised controlled trial. — ASN Events
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The impact of physical activity on fatigue and quality of life in lung cancer patients: a randomised controlled trial. (#23)

Haryana Dhillon 1 , Melanie Bell 2 , Hidde van der Ploeg 3 , Jane Turner 1 , Michael Kabourakis 1 , Lissa Spencer 4 , Craig Lewis 5 , Rina Hui 6 , Prunella Blinman 7 , Stephen Clarke 1 , Michael Boyer 8 , Janette Vardy 7 9
  1. The University of Sydney, Sydney, NSW, Australia
  2. University of Arizona, Tuscon, USA
  3. VU University Medical Center Amsterdam, Amsterdam, The Netherlands
  4. Royal Prince Alfred Hospital, Camperdown, NSW
  5. Prince of Wales Hospital, Randwick
  6. Westmead Hospital, Westmead
  7. Concord Cancer Centre, Concord, NSW, Australia
  8. Chris O'Brien Lifehouse, Camperdown
  9. University of Sydney, Concord, NSW, Australia

Background: Physical activity (PA) has been shown to improve fatigue and quality of life (QOL) in a range of cancer populations.  Little research has been done in the advanced lung cancer setting. This RCT evaluated a 2-month PA intervention in patients with unresectable lung cancer.

Methods: Participants were stratified (disease stage, performance status 0-1 vs 2, centre) and randomised (1:1) to usual care (UC) (health booklet) or UC plus 2-month program of supervised weekly PA and behaviour change sessions and home-based PA.  Assessments were completed at baseline, 2, 4 and 6 months.  The primary endpoint was fatigue (FACT-F subscale) at 2-months. Secondary endpoints included: QOL, functional abilities, physical fitness, activity (accelerometers), mood, dyspnoea, survival and blood results. Intention-to-treat analysis using linear mixed models was done.

Results: 111 patients were randomised: male 55%, median age 62 (35-80); 95% NSCLC, 5% SCLC; 95% Stage IV. At baseline 77% were on active treatment.  Baseline characteristics, including PA levels, were well balanced between groups. Attrition was 22, 36 and 50% at 2, 4 and 6 months respectively; no difference between groups. Adherence to intervention sessions: behavioural 75%, PA 69%. By accelerometers the intervention group increased PA by 33-39mins/week at 2,4 and 6 months (p<0.03); control group had a non-significant decrease of 11-27mins/week (difference between groups p<0.001). The intervention did not reach target increase of 3-MET hours/week. Self-reported PA levels were over-reported compared to accelerometers. On self-report the only significant difference in PA levels between groups was at 4 months (p=0.015). There were no significant differences in fatigue, QOL, symptoms, mood, distress, sleep, dyspnoea, activities of daily living or biological correlates between the groups at 2, 4 or 6 months. Median survival (months): PA 14 vs UC 13.8 (p= 0.61).

Conclusion:

The intervention increased moderate-intensity exercise but did not achieve target levels of PA. No difference was seen in fatigue, QOL, symptom control or functional status.  

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