Group-based versus individualized exercise programs in lung cancer: Results from the randomized crossover LungFit study.

Abstract

e20101 Background: Patients with lung cancer frequently experience reduced functional capacity and impaired quality of life throughout the disease trajectory, regardless of stage. Exercise interventions have demonstrated benefits in oncology; however, evidence comparing different delivery modalities and their implementation in routine care remains limited. LungFit was designed to evaluate the effects of two structured exercise modalities on functional and patient-reported outcomes in patients with lung cancer. Methods: LungFit is a prospective, randomized, controlled crossover clinical study including patients with lung cancer irrespective of disease stage. Participants are randomized at baseline to receive either a group-based or an individualized structured exercise program for three months. After a 15-day washout period and repeat assessment, participants cross over to the alternate exercise modality for an additional three months. Both interventions consist of supervised, tailored exercise programs targeting aerobic capacity, muscle strength, and functional performance. Assessments are conducted at baseline, after the first intervention period, and after completion of both exercise modalities. The primary endpoint is change in functional capacity. Secondary endpoints include quality of life, symptom burden, adherence, feasibility, and patient-reported outcomes related to humanization of care. Results: In this preliminary analysis, 35 participants completed paired functional assessments after first intervention period of exercise. Mean change in the 6-minute walk test (6MWT) was 15.8 m (95% CI −12.2 to 43.9; p = 0.26). Improvement was greater with the individualized intervention compared with the group-based program (22.8 vs 3.0 m; p = 0.49). Functional performance significantly improved in the 30-second sit-to-stand test, with a mean increase of 2.8 repetitions (p < 0.001). No significant changes were observed in Timed Up and Go or handgrip strength. Among 27 participants with paired psychological assessments, HADS-Anxiety slightly decreased and HADS-Depression remained stable, with no significant differences between assessments. Patient satisfaction with the exercise program was high, with mean scores of 4.74 in the group-based intervention and 4.63 in the individualized intervention, without significant differences between modalities (p = 0.62). Conclusions: Structured exercise programs were feasible, well accepted, and associated with improved lower-limb functional performance in patients with lung cancer. Both group-based and individualized modalities showed high satisfaction and comparable short-term outcomes. Full crossover results will further clarify the comparative impact of both delivery formats.