Clinical effect of pulmonary rehabilitation during radiotherapy in lung cancer: A randomized controlled trial.

OBJECTIVES: Radiotherapy for lung cancer can cause lung injury, which may lead to decreased pulmonary function, worsened clinical symptoms, reduced quality of life, and poor prognosis. Given that patients with compromised lung function are more likely to undergo radiotherapy, adjunct treatments to enhance its safety should be explored. We performed this study to determine whether outpatient-based pulmonary rehabilitation (PR) provides positive clinical effects for patients with lung cancer undergoing radiotherapy. METHODS: A randomized controlled trial was conducted between June 2022 and May 2023. Patients were stratified by radiotherapy objectives and assigned to the PR or control groups. The outpatient-based PR program was implemented 2-3 times per week during radiotherapy. RESULTS: Improvements in 6-minute walking distance from baseline were significant in the PR group (16.9 ± 69.9 m vs. -26.1 ± 49.8 m at the end of radiotherapy, P = 0.008; 34.9 ± 39.4 m vs. -24.0 ± 48.3 m at 1-month post-radiotherapy, P < 0.001; 40.7 ± 75.7 m vs. -3.1 ± 47.5 m at 7-month post-radiotherapy, P = 0.043). Grip strength and muscle mass-related parameters showed similar trends. The incidence of radiation pneumonitis requiring steroid treatment was significantly lower in the PR group (9.4 % vs. 54.5 %, P < 0.001). CONCLUSION: PR during radiotherapy for patients with lung cancer improved the 6-minute walking distance and reduced the occurrence of radiation pneumonitis requiring medical intervention. These findings support the integration of PR into radiotherapy for patients with lung cancer. CLINICAL TRIAL REGISTRATION: NCT05414188 at ClinicalTrials.gov (2022-06-10).