QUALITY OF LIFE AFTER PREOPERATIVE HOME-BASED EXERCISE TRAINING IN PATIENTS WITH LUNG CANCER: A RESPONDER ANALYSIS

Pimenta, Sara Pedrosa

http://hdl.handle.net/10400.8/9747

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Authors

Pimenta, Sara Pedrosa

Advisor(s)

Cruz, Joana Patrícia dos Santos

Machado, Pedro Filipe André

Abstract(s)

Introduction and aims: Previously, a preoperative home-based exercise training (PHET) program proved to be effective in improving health-related quality of life (HRQoL) in patients awaiting lung cancer surgery, yet inter-individual variability was observed. This secondary analysis aimed to explore characteristics of responders/non-responders and predictors of response in HRQoL to PHET. A secondary goal was to determine whether the response to PHET (i.e., ‘responders’ and 'non-responders') was associated with clinically relevant changes in HRQoL following lung cancer surgery. Methods: Data from a feasibility study and a randomized controlled trial (experimental group) were analyzed and included sociodemographic/clinical data (comorbidities; Incremental Shuttle Walk test; 5 times sit-to-stand; handgrip strength), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC-QLQ-C30) to assess HRQoL. Responders vs. non-responders were classified using the minimal important difference (5 points) in the Global QoL scale of the EORTC-QLQ-C30 after PHET (1-5 days before surgery). Between-group differences were analyzed through independent samples t-tests, Mann–Whitney U tests, Chi-square/Fisher exact tests depending on data type/distribution. Predictors of response to PHET were analyzed through logistic regressions. Results: 32 patients (63% male, 67.1±7.8 years old) were included, from which 56% (n=18) were responders to PHET in Global QoL scale of the EORTC-QLQ-C30. Responders had lower scores in Global QoL and Emotional Function scales, and in the Summary Score (p<0.05), compared to ‘non-responders’. 50% of responders had COPD (p=0.019). No significant between-group differences were found in performance variables (p>.05). In a regression model including the Summary Score and COPD (Nagelkerke R2=0.511), COPD was the only significant predictor of response: COPD patients were 13.4 times more likely to be responders (OR=13.4; 95% CI 1.4; 132.2). Conclusions: Findings suggest that patients who respond to PHET have lower baseline HRQoL and COPD diagnosis, although only the presence of COPD predicts response to PHET in HRQoL. Patients who respond to PEP tend to maintain or improve HRQoL 1 month after surgery, although this relationship is still unclear. Other predictors of response should be investigated in larger samples.