Background/Objectives: Lung cancer is the commonest cause of cancer death worldwide. Treatment efficacy is improving, but treatment rates remain low. We aimed to assess the impact of tri-modality early prehabilitation (single in-person interventions by a senior doctor in palliative/supportive care, physiotherapist and dietitian) on patients with a radiological diagnosis of lung cancer. Methods: Patients were approached as soon as they were told they had a radiological diagnosis of lung cancer. Prehabilitation took place in parallel with a patient’s investigative pathway for lung cancer. Routine data for admissions and survival was assessed retrospectively for prehabilitation patients and compared to an appropriate group of historical controls. Results: A total of 97 patients with stage 3 or 4 lung cancer underwent prehabilitation and were compared to 199 historical controls. There were no obvious statistical differences in gender or age between the cohorts. There was a trend towards reduced mean length of stay (LOS) from 7.6 days to 2.6 days in the patients who underwent all three interventions and from 7.6 days to 3 days in all comers (p= 0.053), with a significantly shorter admission in those who were admitted (p= 0.0014). There was a reduction in time spent in hospital from 486 days to 172 days per 100 patients receiving prehabilitation (a saving of 3.1 days per patient participating). Survival appeared to improve 6 months after diagnosis, at 61% in the prehabilitation cohort (95% CI: 51.8–72.0%,p= 0.029) vs. 47.7% in the historical controls (95% CI: 41.3–55.2%,p= 0.029). Life-prolonging treatment rates in stage 4 disease increased from 26% to 42% and all-comer best supportive care rates reduced from 45% to 28%. Conclusions: Early prehabilitation appears to reduce time spent in hospital. It may also improve treatment rates and short-term survival in patients being investigated for lung cancer.
背景/目的：肺癌是全球癌症死亡最常见的原因。治疗效果虽在提升，但治疗率仍然偏低。本研究旨在评估早期三联预康复（由姑息/支持治疗高级医师、物理治疗师及营养师各进行一次面对面干预）对影像学诊断为肺癌患者的影响。方法：在患者被告知肺癌影像学诊断后立即接洽。预康复干预与肺癌诊断检查流程同步进行。通过回顾性分析预康复患者的常规住院及生存数据，并与匹配的历史对照组进行比较。结果：共97例III-IV期肺癌患者接受预康复干预，与199例历史对照者进行比较。两组在性别与年龄方面无显著统计学差异。数据显示住院时长呈缩短趋势：完成全部三项干预的患者平均住院日从7.6天降至2.6天，总体干预人群从7.6天降至3天（p=0.053），其中实际住院患者的住院时间显著缩短（p=0.0014）。每百例接受预康复的患者住院总时长从486天减少至172天（平均每例参与者节省3.1天）。诊断后6个月生存率显示改善趋势：预康复组为61%（95% CI：51.8–72.0%，p=0.029），历史对照组为47.7%（95% CI：41.3–55.2%，p=0.029）。IV期疾病患者的延长生命治疗率从26%提升至42%，总体人群的最佳支持治疗率从45%下降至28%。结论：早期预康复可缩短肺癌确诊检查期患者的住院时间，并可能提高治疗率及短期生存率。
肿瘤(癌症)患者之家