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Published on: July 24, 2013
Association between daily step counts and frailty trajectory classes in lung cancer patients undergoing radiotherapy:
Jiang Zhang1, Jiang Wu1,2, Song Li3
1Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, Yunnan Province, China.
Purpose:
To characterize frailty trajectories in patients undergoing radiotherapy with lung cancer, identify factors associated with trajectory membership, and examine the association between daily step counts and frailty trajectories during radiotherapy.
Methods:
In this prospective longitudinal study, daily step counts were collected via the WeChat Step Mini-program from the start to the end of radiotherapy. Frailty was assessed via the Frailty Phenotype Scale before radiotherapy, at the end of radiotherapy, and 1 month after radiotherapy. Latent class growth modeling was used to identify frailty-trajectory classes, and multinomial logistic regression was used to examine associated factors and the relationship between step counts and trajectory membership.
Results:
Among 327 patients, three frailty trajectories were identified: prefrailty declining (56.58%), frailty stable increasing (27.83%), and severe frailty increasing (15.60%) group. After adjustment for demographic and clinical covariates, higher average daily step counts during radiotherapy were independently associated with a lower likelihood of membership in adverse frailty trajectories.
Conclusions:
Frailty trajectories in patients with lung cancer undergoing radiotherapy were heterogeneous. Step-count gradients were observed around 3000, 6000, and 9000 steps/day, suggesting exploratory thresholds for different frailty-risk intervals.
Implications For Cancer Survivors:
Daily step counts are a scalable real-world metric. Combining continuous step monitoring with routine frailty screening may support early identification of high-risk patients and proactive, individualized management during and after radiotherapy.