Early Response of Cardiopulmonary Exercise Test in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Systemic Chemotherapy

Shin, Kyeong Cheol; Chung, Jin Hong; Lee, Kwan Ho

Abstract

BACKGROUND: The effects of chemotherapy on pulmonary function are mainly a reduced diffusion capacity and a restrictive ventilatory impairment. Exercise can expose cardiovascular and pulmonary abnormalities not evident at rest. Exercise related cardiopulmonary function is important in patients with malignant disease as a determinant of quality of life. We performed this study to evaluate the changes of body composition and cardiopulmonary exercise performance of patients with locally advanced, non-small cell, lung cancer (NSCLC) before and after chemotherapy.
METHODS
We evaluated resting pulmonary function, body composition, physiologic performance status, and cardiopulmonary exercise function in 11 patients with locally advanced NSCLC, at diagnosis and prior to the fourth cycle of chemotherapy.
RESULTS
After chemotherapy, 4 patients (36.4%) showed partial response and 7 (63.4%) had stable disease. After chemotherapy, diffusion capacity of the lung for carbon monoxide was reduced (89.7+/-34.1%, vs. 71.9+/-20.5%) but not significantly. There were no significant changes in body composition or the state of physiologic performance after chemotherapy. There was a significant impairment of cardiopulmonary exercise tolerance in patients with NSCLC, evidenced by a reduction of maximal oxygen uptake (VO2max, ml/kg/min, 17.9+/-2.6 : 12.6+/-6.1, <0.05) and O2 pulse (O2 pulse, ml/beat, 7.0+/-1.7, 5.2+/-2.1, <0.05).
CONCLUSION
Systemic chemotherapy resulted in a loss of cardiopulmonary exercise function in patients with locally advanced NSCLC within the short-term period, but not a physiologic change of body composition within the same period.