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Abstract
An increase in the life expectancy of resectable non-small cell lung cancer (NSCLC) patients after complex treatment is associated with psychological and physical impairments that reduce the overall quality of life. The article evaluates the efficacy of rehabilitation programs in NSCLC patients, considering recommended technologies (RT) of physical and rehabilitation medicine (personalized approach) in comparison to standard rehabilitation methods.
Materials and methods. The study included 240 patients with resectable NSCLC aged 45 to 71 years (median 60.2 years) who underwent rehabilitation as part of combined/complex treatment at the N.N. Petrov NMRC of Oncology between 2017 and 2022. Patients in the experimental group received personalized rehabilitation, while the control group underwent standard rehabilitation. The control group patients were paired based on key characteristics, including gender, age, functional status, histological subtype, disease stage, and treatment volume. The dynamics of patient parameters were evaluated in the pre-/post-operative period, immediately after implementing the rehabilitation programs, and one year later. The evaluation included an assessment of clinical status indicators (mMRC scale, COMP scale, VAS, 6-minute walk test), functional (PFTs) and psychophysiological parameters (MFI-20 scale, HADS scale), as well as quality of life indicators (EORTC-QLQ30).
Results. Analysis of rehabilitation effectiveness in NSCLC patients showed that the personalized rehabilitation model in the experimental group was effective in 86 % of cases, whereas standard rehabilitation programs in the control group were effective in 76 % of cases. The main determinants influencing the therapeutic effect following the application of rehabilitation programs tailored to the selected RTs are: the parameters of external respiration function (VC – vital capacity, PEFR – peak expiratory flow rate, MEF – mean expiratory flow rate), the 6-minute walk test, dyspnea severity scales (Modified Medical Research Council, mMRC), and activities of daily living (Canadian Occupational Performance Measure, COMP).
Conclusion. Identified determinants will allow for the early prediction of the effectiveness of rehabilitation technologies in specific models of resectable NSCLC patients, taking into account initial parameters.
References
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