Background and objective: Exercise can improve circulation, muscular strength and happiness of cancer survivors. But more data were needed to demonstrate both the exercise ability of cancer suivivors after pulmonary lobectomy and the influences of exercise on their survivals. The aim of this study was to examine changes of exercise and its clinical effects among eldly non-small cell lung cancer survivors.
Methods: Elderly non-small cell lung cancer survivors who had progression-free disease after surgery, chemotherapy, radiation therapy or tyrosine kinase inhibitors were included. Their exercises and participation rates per week before cancer diagnosis, after 3 months anticancer therapy and 1 year after diagnosis as well as their exercise motivations and prevalences were investigated retrospectively.
Results: Forty-eight elderly non-small cell lung cancer survivors were selected. Moderate-vigorous intensity exercise had by the elderly progressin-free non-small cell lung cancer survivors after diagnosis decreased, but the participation rate of light intensity exercise was higher in 1 year after diagnosis than before diagnosis. 75.9% (14/58) patients had exercise up to the standard and the cancer recurrence rate was 20.0% (7/35). The recurrence rate of the other group was 35.7% (5/14), and the risk ratio of recurrence was 2.14 (95% CI: 0.81-5.68, P = 0.26). The most common motivations of exercise were improving health, increasing physical activity, maintaining healthy life style and improving immunity. And the main disturbances were fatigue, discomfort and lack of motivation.
Conclusion: The exercise participation rate during anticancer treatment among the elderly non-small cell lung cancer survivors decreased and did not return to prediagnosis levels after treatments were completed. The relationship between exercise and recurrence of cancer was not clear and needed further work.
背景与目的: 运动对健康有重要影响，可以提高癌症生存者的心血管系统功能、肌力和幸福感等，并减少乏力、焦虑、抑郁等。但目前关于肺癌患者治疗后运动能力的改变及其与肿瘤复发的关系目前尚不明了。本研究拟探讨老年非小细胞肺癌生存者体能锻炼行为模式的改变和临床意义。
方法: 采用回顾分析方法，调查包括手术后、化放疗后病情稳定者和服用酪氨酸激酶抑制剂行靶向治疗的老年肺癌生存者，记录其诊断前、积极治疗3个月和1年的运动量和每周运动频率，了解患者运动动机和偏好，探讨运动与肿瘤复发的关系。
结果: 调查了58例老年肺癌生存者，发现治疗期间老年肺癌生存者的体能锻炼参与比例下降，但1年后平均轻度体力活动较治疗前有增加。1年后运动基本达标的患者占75.9%（44/58），肺癌复发/进展率为20.0%（7/35），不达标的患者占24.1%（14/58），复发/进展率为35.7%（5/14），运动不达标时肿瘤复发/进展的风险比（risk ratio, RR）为2.14（95%CI:0.81-5.68, P=0.26）。肿瘤生存者运动的动机主要有改善健康、增加体能，维持正常生活方式、增加免疫力等，而最常见的障碍是疲乏、不舒服和缺少动机等。
结论: 治疗期间老年肺癌生存者的体能锻炼参与比例降到原有的10%以下，而且即便是治疗完成后也不能恢复到诊断前的水平，运动不达标时和运动达标时患者肿瘤复发/进展的情况无明显差异，运动与肿瘤复发的关系有待进一步研究。