[Can Pulmonary Rehabilitation during Preoperative Chemoradiotherapy for Non-small Cell Lung Cancer Improve the...

Chemoradiotherapy for non-small cell lung cancer (NSCLC) can impair pulmonary function, particularly when it is followed by surgery. This study aimed to document the changes in respiratory function as a result of a perioperative intensive pulmonary rehabilitation program in patients with NSCLC who underwent induction chemoradiotherapy.

A total of 82 consecutive patients underwent pulmonary resection after undergoing induction chemoradiotherapy. A pulmonary rehabilitation program was started at the same time as the induction chemoradiotherapy. Standard respiratory function tests were performed before and after induction chemoradiotherapy. Treatment-related mortality and the incidence of postoperative respiratory complications were investigated. The Wilcoxon signed-rank test was used to analyze the differences in spirometric changes.

All patients underwent a pulmonary rehabilitation program for an average of 10 weeks. Significant increases were observed in forced vital capacity (FVC) [+6.4%, p=.0096] and forced expiratory volume in 1 second( FEV(1))[ +10.4%, p<.0001]. Diffusing capacity of the lung for carbon monoxide decreased(-14.0%, p<.0001). Patients with respiratory impairment (FVC <80% predicted or FEV(1)/FVCp<70%) showed significant improvements in FVC( +13.9%, p=.0025) and FEV(1)( +22.5%, p<.0001). Significant increases were observed in FVC( +7.0%, p=.0042) and FEV(1)( +10.8%, p<.0001) in patients with a smoking history. There was no mortality, and postoperative respiratory morbidity was 6.1%.