Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial

H M Dhillon; M L Bell; H P van der Ploeg; J D Turner; M Kabourakis; L Spencer; C Lewis; R Hui; P Blinman; S J Clarke; M J Boyer; J L Vardy

doi:10.1093/annonc/mdx205

Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial

Ann Oncol. 2017 Aug 1;28(8):1889-1897. doi: 10.1093/annonc/mdx205.

Authors

H M Dhillon¹, M L Bell², H P van der Ploeg³, J D Turner¹, M Kabourakis¹, L Spencer⁴, C Lewis⁵, R Hui⁶, P Blinman⁷, S J Clarke⁸, M J Boyer⁹, J L Vardy^{1

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Affiliations

¹ Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia.
² Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.
³ Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
⁴ Physiotherapy Department, Royal Prince Alfred Hospital, Camperdown.
⁵ Medical Oncology Department, Prince of Wales Hospital, Randwick.
⁶ Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead.
⁷ Concord Cancer Centre, Concord Repatriation General Hospital, Concord.
⁸ Sydney Medical School, University of Sydney, Sydney.
⁹ Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, Australia.

PMID: 28459989
DOI: 10.1093/annonc/mdx205

Abstract

Background: Physical activity (PA) improves fatigue and quality of life (QOL) in cancer survivors. Our aim was to assess whether a 2-month PA intervention improves fatigue and QOL for people with advanced lung cancer.

Methods: Participants with advanced lung cancer, Eastern Cooperative Oncology Group performance status (PS) ≤2, >6 months life expectancy, and ability to complete six-min walk test, were stratified (disease stage, PS 0-1 versus 2, centre) and randomized (1:1) in an open-label study to usual care (UC) (nutrition and PA education materials) or experimental intervention (EX): UC plus 2-month supervised weekly PA and behaviour change sessions. Assessments occurred at baseline, 2, 4, and 6 months. The primary endpoint was fatigue [Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire] at 2 months. The study was designed to detect a difference in mean FACT-F subscale score of 6. Analysis was intention-to-treat using linear mixed models.

Results: We recruited 112 patients: 56 (50.4%) were randomized to EX, 55(49.5%) to UC; 1 ineligible. Male 55%; median age 64 years (34-80); 106 (96%) non-small cell lung cancer; 106 (95.5%) stage IV. At 2, 4 and 6 months, 90, 73 and 62 participants were assessed, respectively, with no difference in attrition between groups. There were no significant differences in fatigue between the groups at 2, 4 or 6 months: mean scores at 2 months EX 37.5, UC 36.4 (difference 1.2, 95% CI - 3.5, 5.8, P = 0.62). There were no significant differences in QOL, symptoms, physical or functional status, or survival.

Conclusions: Adherence to the intervention was good but the intervention group did not increase their PA enough compared to the control group, and no difference was seen in fatigue or QOL.

Trial registration: Australian New Zealand Clinical Trials Registry No. ACTRN12609000971235.

Keywords: fatigue; lung cancer; physical activity; quality of life.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / physiopathology*
Exercise*
Fatigue*
Female
Humans
Lung Neoplasms / physiopathology*
Male
Middle Aged
Quality of Life*