Real-life feasibility of home-based pulmonary rehabilitation in chemotherapy-treated patients with thoracic cancers: a pilot study
Cecile Olivier,
Jean-Marie Grosbois,
Alexis B. Cortot,
Sophie Peres,
Christophe Heron,
Julie Delourme,
Marianne Gierczynski,
Anne Hoorelbeke,
Arnaud Scherpereel,
Olivier Le Rouzic
Affiliations
Cecile Olivier
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Jean-Marie Grosbois
FormAction Santé
Alexis B. Cortot
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Sophie Peres
Santelys Association
Christophe Heron
Nutrition Department, CHU Lille
Julie Delourme
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Marianne Gierczynski
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Anne Hoorelbeke
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Arnaud Scherpereel
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Olivier Le Rouzic
CHU Lille, Department of Respiratory Diseases, MESOCLIN, Center for Infection and Immunity of Lille (INSERM U1019 – UMR 8204 – Pasteur Institute of Lille), University of Lille
Abstract Background Patients with advanced lung cancer (LC) or malignant pleural mesothelioma (MPM) exhibit limitation of exercise capacities and alteration of quality of life (QoL) induced by cancer and its treatment. Few studies assessed pulmonary rehabilitation (PR) in these chemotherapy-treated patients, and none evaluated a home-based PR program. Methods In this prospective uncontrolled observational pilot study, patients treated by chemotherapy for LC or MPM were screened for a home-based PR program combining exercise training with global cares including therapeutic education and psychosocial management. Feasibility and safety were evaluated by attendance and adherence to PR program. Various exercise tolerance tests, including 6-min walk test (6MWT) and 6-min stepper test (6MST), were performed before and after PR associated with, QoL and psychological assessment (VSRQ and HAD, respectively). Results 243 patients were considered eligible but only 71 (60.6 ± 8.8 years) started a PR and 47 completed the program. Refusals to participate were mostly related to lack of motivation whereas withdrawals to PR were related to cancer-related medical issues. No adverse event related to PR was observed. Baseline 6MWT distance was associated with performance status (r = − 0.45, p = 0.001) and mMRC dyspnea scale (r = − 0.49, p < 0.001) but not with lung cancer stage. Post-PR reassessment showed 6MWT stability and 6MST improvement in patients who completed the program. Daily physical activity (p = 0.007) and anxiety (p = 0.02) scores were significantly improved. Conclusions Home-based PR was feasible and safe in patients with advanced LC or MPM. Exercise capacities stability in patients who completed the PR program suggests that PR might be beneficial. Further studies are warranted to confirm and to improve the potential value of PR in these patients.
