Association between physical activity and health-related quality of life: time to deterioration model analysis in lung adenocarcinoma

Jinman Zhuang; Yuhang Liu; Xinying Xu; Yuxin Cai; Maolin Liu; Zishan Chen; Shuyan Yang; Jianbo Lin; Zhijian Hu; Mingqiang Kang; Mengxin Lin; Fei He

doi:10.1007/s11764-022-01259-z

Association between physical activity and health-related quality of life: time to deterioration model analysis in lung adenocarcinoma

J Cancer Surviv. 2023 Dec;17(6):1769-1779. doi: 10.1007/s11764-022-01259-z. Epub 2022 Oct 4.

Authors

Jinman Zhuang¹, Yuhang Liu¹, Xinying Xu¹, Yuxin Cai², Maolin Liu¹, Zishan Chen¹, Shuyan Yang¹, Jianbo Lin³, Zhijian Hu^{1

4

5}, Mingqiang Kang⁶, Mengxin Lin⁷, Fei He^{8

9

10

11}

Affiliations

¹ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, 350122, Fuzhou Fujian Province, China.
² Department of Health Toxicology, School of Public Health, Xiamen University, Xiamen, China.
³ Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
⁴ Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
⁵ Fujian Digital Tumor Data Research Center, Fuzhou, China.
⁶ Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
⁷ Department of Oncology, Fujian Medical University Union Hospital, Fujian Province, 350000, China. exlibralmx@163.com.
⁸ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, 350122, Fuzhou Fujian Province, China. i.fei.he@fjmu.edu.cn.
⁹ Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China. i.fei.he@fjmu.edu.cn.
¹⁰ Fujian Digital Tumor Data Research Center, Fuzhou, China. i.fei.he@fjmu.edu.cn.
¹¹ Department of Pulmonary and Critical Care Medicine, Respirology Medicine Centre of Fujian Province, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China. i.fei.he@fjmu.edu.cn.

Abstract

BACKGROUND AND PURPOSE : Health-related quality of life (HRQoL) is a key aspect of care for cancer survivors that can be improved by physical activity. Our aim was to explore the relationship between physical activity and time to deterioration (TTD) of the HRQoL in patients with lung adenocarcinoma (LUAD).

Methods: We conducted a hospital-based prospective study. The International Physical Activity Questionnaire long-form (IPAQ-L) was used to investigate the pre-treatment physical activity levels, and the EORTC Quality of Life Questionnaire version 3.0 (EORTC QLQ-C30) and EORTC Quality of Life Questionnaire-Lung Cancer (EORTC QLQ-LC13) were used to assess HRQoL at baseline and during follow-up. The QoLR package was used to calculate the HRQoL scores and determine TTD events (minimal clinically important difference=5 points). The effect of physical activity on the HRQoL was assessed using Cox regression analysis.

Results: For EORTC QLQ-C30, TTD events of physical functioning (PF) and dyspnea (DY) in functional scales and symptom scales were the most common during follow-up. Pre-treatment physical activity was found to significantly delay TTD of insomnia (HR=0.635, 95%CI: 0.437-0.922, P=0.017) and diarrhea (HR=0.475, 95%CI: 0.291-0.774, P=0.003). For EORTC QLQ-LC13 scales, deterioration of dyspnea (LC-DY) was the most common event. Physical activity was found to delay the TTD of dyspnea (HR=0.654, 95%CI: 0.474-0.903, P=0.010), sore mouth (HR=0.457, 95%CI: 0.244-0.856, P=0.015), and dysphagia (HR=0.315, 95%CI: 0.172-0.580, P<0.001).

Conclusions: Pre-treatment physical activity of LUAD patients may delay the TTD of multiple HRQoL indicators in EORTC QLQ-C30 and EORTC QLQ-LC13.

Implication for cancer survivors: Health-related quality of life (HRQoL) is a key aspect of care for cancer survivors (someone who is living with or beyond cancer), that can be improved by physical activity. Our aim was to explore the relationship between physical activity and time to deterioration (TTD) of the HRQoL in patients with lung adenocarcinoma (LUAD).

Keywords: Health-related quality of life; Lung adenocarcinoma; Physical activity; Time to deterioration.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adenocarcinoma of Lung*
Cancer Survivors*
Dyspnea
Humans
Lung Neoplasms*
Prospective Studies
Quality of Life
Surveys and Questionnaires