Purpose: 

Few programs exist to address persistent impairment in functional status, quality of life, and mental health in lung cancer survivors. We aimed to determine whether a 12-wk multimodal survivorship program imparts clinical benefit.

Methods: 

Any patient at the Durham Veterans Affairs Medical Center with lung cancer and a Karnofsky score of ≥60 could participate. Chronic obstructive pulmonary disease medications were optimized at the enrollment visit. Participants with a Hospital Anxiety and Depression Scale (HADS) score of >8 were offered pharmacotherapy and mental health referral. Participants did home-based exercise with a goal of 1 hr/d, 5 d/wk. They were called weekly to assess exercise progress and review depression/anxiety symptoms. Participants were offered pharmacotherapy for smoking cessation.

Results: 

Twenty-three (50%) of the first 46 enrollees completed the full 12-wk program. Paired changes from enrollment to completion (mean ± SD) were observed in 6-min walk test (73.6 ± 96.9 m, P = .002), BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise) index (−1.45 ± 1.64 points, P < .001), Duke Activity Status Index (3.84 ± 7.12 points, P = .02), Fried Frailty Index (−0.588 ± 0.939 points, P = .02), modified Medical Research Council dyspnea scale (−0.619 ± 1.284 points, P = .04), Functional Assessment of Cancer Therapy-Lung Emotional subscale score (1.52 ± 2.96 points, P = .03), HADS total score (−2.63 ± 4.34 points, P = .02), and HADS Anxiety subscale score (−1.47 ± 2.29 points, P = .01).

Conclusions: 

A comprehensive Lung Cancer Survivorship Program provides clinically meaningful improvements in functional status, quality of life, and mental health.

中文翻译：

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基于退伍军人事务部的综合肺癌生存计划的实施和有效性

目的： 

很少有项目能够解决肺癌幸存者功能状态、生活质量和心理健康方面的持续损害。我们的目的是确定为期 12 周的多模式生存计划是否能带来临床益处。

方法： 

达勒姆退伍军人事务医疗中心的任何患有肺癌且卡诺夫斯基评分≥60 的患者都可以参加。慢性阻塞性肺疾病药物在入组访视时进行了优化。医院焦虑和抑郁量表 (HADS) 评分 >8 的参与者接受了药物治疗和心理健康转诊。参与者进行家庭锻炼，目标是每天 1 小时、每周 5 天。他们每周都会被打电话评估锻炼进度并检查抑郁/焦虑症状。为参与者提供戒烟药物治疗。

结果： 

前 46 名参与者中的 23 名 (50%) 完成了完整的 12 周计划。在 6 分钟步行测试（73.6 ± 96.9 m，P = .002）、BODE（体重指数、气流阻塞、呼吸困难和运动）指数（−1.45 ± 1.64 分，P < .001），杜克活动状态指数（3.84 ± 7.12 分，P = .02），Fried 虚弱指数（−0.588 ± 0.939 分，P = .02），改良医学研究委员会呼吸困难量表（−0.619） ± 1.284 分，P = .04），癌症治疗功能评估-肺情绪分量表评分（1.52 ± 2.96 分，P = .03），HADS 总分（−2.63 ± 4.34 分，P = .02）和 HADS焦虑分量表得分（−1.47 ± 2.29 分，P = .01）。

结论： 

全面的肺癌生存计划可在功能状态、生活质量和心理健康方面提供具有临床意义的改善。