Meta-analysis for the effect of preoperative pulmonary rehabilitation on lung cancer patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHEN Weihai ¹ , LI Jian’an ² , XU Bin ³ , WU Yanming ¹ , SHEN Jun ¹ , NI Jun ⁴ ,  YOU Hua ¹

1. Department of Cardiology, Suzhou Ninth People’s Hospital, Suzhou, Jiangsu 215200, P. R. China;
2. Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P. R. China;
3. Nursing Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P. R. China;
4. Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226000, P. R. China;

Corresponding author：

YOU Hua, Email: 13861909863@163.com

Keywords：

Lung cancer; Preoperative pulmonary rehabilitation; Meta-analysis

DOI：

10.7507/1671-6205.201903062

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Objective To clarify the effectiveness of preoperative pulmonary rehabilitation (PPR) and provide evidence for the application of PPR on lung cancer patients by meta-analysis.Methods According to inclusion and exclusion criteria, literatures related to PPR on lung cancer patients were retrieved from major databases between the date of establishment of each database and January 2019, and then data required were extracted from the selected literatures. Meta-analysis was conducted by RevMan 5.0.Results Twelve randomized controlled trials were involved in meta-analysis, including 658 patients who were well-diagnosed and prepared for surgery, with 307 patients in the PPR group and 351 patients in the control group. The results of the meta-analysis showed that in the PPR group, the pulmonary function including forced vital capacity [MD=0.31, 95%CI (0.21, 0.42), P<0.01], forced expiratory volume in one second [MD=0.27, 95%CI (0.20, 0.34), P<0.01] and activity tolerance including 6-minute walk distance [MD=50.55, 95%CI (35.98, 65.13), P<0.01] were significantly better than the control group, and the postoperative complication rate was lower ［MD=0.28, 95%CI (0.18, 0.43), P<0.01］, postoperative hospital stay was shorter [MD=–2.09, 95%CI (–2.41, –1.77), P<0.01].Conclusions A period of PPR on lung cancer patients can improve postoperative pulmonary function and activity tolerance, and reduce postoperative complications and hospital stay, which is beneficial to postoperative recovery.

Citation： CHEN Weihai, LI Jian’an, XU Bin, WU Yanming, SHEN Jun, NI Jun, YOU Hua. Meta-analysis for the effect of preoperative pulmonary rehabilitation on lung cancer patients. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(6): 568-576. doi: 10.7507/1671-6205.201903062 Copy

1.	王维琼. 2016 年中国恶性肿瘤发病和死亡分析. 临床医药文献电子杂志, 2017, 4(19): 3604-3604.
2.	支修益, 石远凯, 于金明. 中国原发性肺癌诊疗规范(2015 年版). 中华肿瘤杂志, 2015, 37(1): 67-78.
3.	Loganathan RS, Stover DE, Shi W, et al. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest, 2006, 129(5): 1305-1312.
4.	Arbane G, Tropman D, Jackson D, et al. Evaluation of an early exercise intervention after thoracotomy for non-small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. Lung Cancer, 2011, 71(2): 229-34.
5.	Cesario A, Ferri L, Galetta D, et al. Post-operative respiratory rehabilitation after lung resection for non-small cell lung cancer. Lung Cancer, 2007, 57(2): 175-180.
6.	Granger CL, Chao C, Mcdonald CF, et al. Safety and feasibility of an exercise intervention for patients following lung resection: a pilot randomized controlled trial. Integr Cancer Ther, 2013, 12(3): 213-224.
7.	王远, 姚继方, 杨俊英. 康复锻炼对肺癌术后患者肺功能恢复结局的影响. 中国组织工程研究, 2005, 9(24): 66-68.
8.	潘友民, 潘铁成, 张良华, 等. 呼吸训练改善肺癌患者手术后肺功能和生存质量的临床研究. 中华物理医学与康复杂志, 2005, 27(9): 548-550.
9.	Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Resp Crit Care, 2013, 188(8): 13-64.
10.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series[M]//Cochrane handbook for systematic reviews of interventions /. 2008.
11.	Sekine Y, Chiyo M, Iwata T, et al. Perioperative rehabilitation and physiotherapy for lung cancer patients with chronic obstructive pulmonary disease. Jpn J Thorac Cardiovasc Surg, 2005, 53(5): 237-243.
12.	Pehlivan E, Turna A, Gurses A, et al. The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Ann Thorac Cardiovas, 2011, 17(17): 461-468.
13.	Benzo R, Wigle D, Novotny P, et al. Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer, 2011, 74(3): 441-445.
14.	Morano MT, Araújo AS, Nascimento FB, et al. Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial. Arch Phys Med Rehab, 2013, 94(1): 53-58.
15.	方翼, 赵擎宇, 黄东锋, 等. 运动训练对低肺功能肺癌患者手术耐受性的影响. 中国康复医学杂志, 2013, 28(7): 619-623.
16.	张慧明, 赵岳. 术前肺康复运动训练对老年肺癌合并中度慢性阻塞性肺疾病病人肺康复的影响. 护理研究, 2014, 28(5A): 1625-1627.
17.	于艳萍. 护理干预联合肺康复运动对肺癌全肺切除术患者肺功能恢复及并发症的影响. 实用临床护理学电子杂志, 2016, 1(5): 139-140.
18.	朱红霞, 杨新雅, 包晓燕. 强化肺康复锻炼在重度肺通气功能障碍肺癌患者围手术期中的应用. 中国肿瘤临床与康复, 2016, 23(11): 1360-1363.
19.	Lai Y, Huang J, Yang M, et al. Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial. J Surg Res, 2017, 209: 30-36.
20.	高珂, 赖玉田, 黄健, 等. 非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白 D (SP-D) 改变与术后肺部并发症相关性的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(5): 330-337.
21.	赖玉田, 苏建华, 杨梅, 等. 术前短期综合肺康复训练对肺癌合并轻中度慢性阻塞性肺病患者的影响: 一项前瞻性随机对照试验. 中国肺癌杂志, 2016, 19(11): 746-753.
22.	刘明强, 洪志鹏. 肺肿瘤手术治疗的现状与未来. 中华肺部疾病杂志(电子版), 2013, 6(1): 53-55.
23.	支修益, 刘宝东. 微创物理靶向治疗肺癌的首选技术——射频消融. 结核病与肺部健康杂志, 2013, 2(1): 5-6.
24.	宋雪. 基于超高效液相色谱—质谱联用的肺癌代谢组学轮廓分析[D]. 大连医科大学, 2013.
25.	Ogawa F, Miyata S, Nakashima H, et al. Clinical impact of lung age on postoperative complications in non–small cell lung cancer patients aged >70y. J Surg Res, 2014, 188(2): 373.
26.	倪高顺, 陈洋. 综合物理治疗对肺癌合并慢性阻塞性肺疾病患者术后肺功能的影响. 中国呼吸与危重监护杂志, 2017, 16(4): 318-323.
27.	Cesario A, Ferri L, Galetta D, et al. Pre-operative pulmonary rehabilitation and surgery for lung cancer. Lung Cancer, 2007, 57(1): 118-119.
28.	Stefanelli F, Meoli I, Cobuccio R, et al. High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Eur J Cardiothorac Surg, 2013, 44(4): e260-e265.
29.	车国卫, 刘伦旭. 肺康复训练有助于肺癌患者术后快速康复吗?. 中国胸心血管外科临床杂志, 2017, 24(8): 575-579.

1. 王维琼. 2016 年中国恶性肿瘤发病和死亡分析. 临床医药文献电子杂志, 2017, 4(19): 3604-3604.
2. 支修益, 石远凯, 于金明. 中国原发性肺癌诊疗规范(2015 年版). 中华肿瘤杂志, 2015, 37(1): 67-78.
3. Loganathan RS, Stover DE, Shi W, et al. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest, 2006, 129(5): 1305-1312.
4. Arbane G, Tropman D, Jackson D, et al. Evaluation of an early exercise intervention after thoracotomy for non-small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. Lung Cancer, 2011, 71(2): 229-34.
5. Cesario A, Ferri L, Galetta D, et al. Post-operative respiratory rehabilitation after lung resection for non-small cell lung cancer. Lung Cancer, 2007, 57(2): 175-180.
6. Granger CL, Chao C, Mcdonald CF, et al. Safety and feasibility of an exercise intervention for patients following lung resection: a pilot randomized controlled trial. Integr Cancer Ther, 2013, 12(3): 213-224.
7. 王远, 姚继方, 杨俊英. 康复锻炼对肺癌术后患者肺功能恢复结局的影响. 中国组织工程研究, 2005, 9(24): 66-68.
8. 潘友民, 潘铁成, 张良华, 等. 呼吸训练改善肺癌患者手术后肺功能和生存质量的临床研究. 中华物理医学与康复杂志, 2005, 27(9): 548-550.
9. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Resp Crit Care, 2013, 188(8): 13-64.
10. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series[M]//Cochrane handbook for systematic reviews of interventions /. 2008.
11. Sekine Y, Chiyo M, Iwata T, et al. Perioperative rehabilitation and physiotherapy for lung cancer patients with chronic obstructive pulmonary disease. Jpn J Thorac Cardiovasc Surg, 2005, 53(5): 237-243.
12. Pehlivan E, Turna A, Gurses A, et al. The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Ann Thorac Cardiovas, 2011, 17(17): 461-468.
13. Benzo R, Wigle D, Novotny P, et al. Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer, 2011, 74(3): 441-445.
14. Morano MT, Araújo AS, Nascimento FB, et al. Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial. Arch Phys Med Rehab, 2013, 94(1): 53-58.
15. 方翼, 赵擎宇, 黄东锋, 等. 运动训练对低肺功能肺癌患者手术耐受性的影响. 中国康复医学杂志, 2013, 28(7): 619-623.
16. 张慧明, 赵岳. 术前肺康复运动训练对老年肺癌合并中度慢性阻塞性肺疾病病人肺康复的影响. 护理研究, 2014, 28(5A): 1625-1627.
17. 于艳萍. 护理干预联合肺康复运动对肺癌全肺切除术患者肺功能恢复及并发症的影响. 实用临床护理学电子杂志, 2016, 1(5): 139-140.
18. 朱红霞, 杨新雅, 包晓燕. 强化肺康复锻炼在重度肺通气功能障碍肺癌患者围手术期中的应用. 中国肿瘤临床与康复, 2016, 23(11): 1360-1363.
19. Lai Y, Huang J, Yang M, et al. Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial. J Surg Res, 2017, 209: 30-36.
20. 高珂, 赖玉田, 黄健, 等. 非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白 D (SP-D) 改变与术后肺部并发症相关性的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(5): 330-337.
21. 赖玉田, 苏建华, 杨梅, 等. 术前短期综合肺康复训练对肺癌合并轻中度慢性阻塞性肺病患者的影响: 一项前瞻性随机对照试验. 中国肺癌杂志, 2016, 19(11): 746-753.
22. 刘明强, 洪志鹏. 肺肿瘤手术治疗的现状与未来. 中华肺部疾病杂志(电子版), 2013, 6(1): 53-55.
23. 支修益, 刘宝东. 微创物理靶向治疗肺癌的首选技术——射频消融. 结核病与肺部健康杂志, 2013, 2(1): 5-6.
24. 宋雪. 基于超高效液相色谱—质谱联用的肺癌代谢组学轮廓分析[D]. 大连医科大学, 2013.
25. Ogawa F, Miyata S, Nakashima H, et al. Clinical impact of lung age on postoperative complications in non–small cell lung cancer patients aged >70y. J Surg Res, 2014, 188(2): 373.
26. 倪高顺, 陈洋. 综合物理治疗对肺癌合并慢性阻塞性肺疾病患者术后肺功能的影响. 中国呼吸与危重监护杂志, 2017, 16(4): 318-323.
27. Cesario A, Ferri L, Galetta D, et al. Pre-operative pulmonary rehabilitation and surgery for lung cancer. Lung Cancer, 2007, 57(1): 118-119.
28. Stefanelli F, Meoli I, Cobuccio R, et al. High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Eur J Cardiothorac Surg, 2013, 44(4): e260-e265.
29. 车国卫, 刘伦旭. 肺康复训练有助于肺癌患者术后快速康复吗?. 中国胸心血管外科临床杂志, 2017, 24(8): 575-579.

Chinese Journal of Respiratory and Critical Care Medicine

Meta-analysis for the effect of preoperative pulmonary rehabilitation on lung cancer patients

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