Lung Cancer 75 (2012) 203–208 Contents lists available at ScienceDirect Lung Cancer j our na l ho me p age: www.elsevier.com/locate/lungcan Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: A pilot study Morten Quist a,∗ , Mikael Rørth b , Seppo Langer b , Lee W. Jones c , Jørgen H. Laursen d , Helle Pappot b , Karl Bang Christensen e , Lis Adamsen f a The University Hospitals Centre for Nursing and Care Research (UCSF) Department 7331, University Hospital Copenhagen, Denmark b Dept. of Oncology 5073, Copenhagen University Hospital, Rigshospitalet, Denmark c Duke University Medical Centre, Durham, USA d Dept. of Oncology 5111, Copenhagen University Hospital, Denmark e Department of Biostatistics, University of Copenhagen, Denmark f Institute of Public Health, University of Copenhagen (UCSF), Denmark a r t i c l e i n f o Article history: Received 11 April 2011 Received in revised form 22 June 2011 Accepted 11 July 2011 Keywords: Advanced lung cancer Aerobic exercise Functional capacity Quality of life Chemotherapy a b s t r a c t Aim: To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy. Methods: A prospective, single-arm intervention study of supervised, hospital based muscle and cardio- vascular group training and individual home-based training. Peak oxygen consumption (VO 2peak ) was assessed using an incremental exercise test. Muscle strength was measured with one repetition maxi- mum test (1RM). HRQOL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. Results: Twenty-five patients with non-small cell cancer (NSCLC) stage III–IV and four patients with exten- sive disease small cell lung cancer (SCLC-ED) were recruited. Six patients (20.7%) dropped out leaving 23 patients for analysis. Exercise adherence in the group training was 73.0% and 8.7% in the home-based training. There were improvements in estimated VO 2peak and six-minute walk distance (6 MWD) as well as increased muscle strength measurements (p < 0.05). There was significant improvement in the “emotional well-being” parameter (FACT-L) while there were no significant changes in HRQOL. Conclusion: Exercise training produces significant improvements in physiological indices and emotional HRQOL and is safe and feasible in patients with advanced stage lung cancer, undergoing chemotherapy. No analysis on home-based training was done because of low adherence. © 2011 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Physical exercise in selected groups of cancer patients can relieve the burden of disease symptoms and side effects from anti- cancer treatment, e.g. poor exercise tolerance, fatigue, depression and anxiety [1–4]. The benefits of physical exercise for cancer patients are described in a series of studies [5–11], most of which included patients with breast cancer and haematological neo- plasias. The studies measured HRQOL and functional capacity and included patients groups with early stage disease. Only two exer- cise intervention studies have included patients with lung cancer who were undergoing chemotherapy [12,13] and only one study, ∗ Corresponding author at: The University Hospital’s Centre for Nursing and Care Research (UCSF) Department 7331, University Hospital Copenhagen, Denmark. Tel.: +45 35457335. E-mail address: m.quist@rh.regionh.dk (M. Quist). Temel et al. [12] investigated the effect of physical training in advanced lung cancer (NSCLC III–IV) and found no significant improvement or decline in HRQOL, anxiety, depression, and phys- ical function (assessed by six minutes walking distance (6 MWD)). However, significant improvement was demonstrated in strength in a single muscle group. Other studies have shown significant improvements following exercise intervention in quality of life and physical function (6 MWD) as well as physical capacity (VO 2peak and 1RM) in patients with lung cancer who were at an earlier stage of disease (NSCLC I–III, SCLC LD) [13–17]. Moreover, it has been shown that physical activity and relax- ation training can relieve side-effects and symptoms in cancer patients with advanced disease who are undergoing chemother- apy [18–20]. It is not known whether these benefits of physical activity can be achieved in patients with advanced NSCLC and SCLC during chemotherapy. We investigated the impact on aer- obic capacity (VO 2peak ), muscle strength (1RM), and quality of life (HRQOL) in patients with lung cancer (NSCLC stage III–IV 0169-5002/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.lungcan.2011.07.006