Characterization of Dyspnea in Lung Cancer Survivors Following Curative-Intent Therapy

Abstract

word count 250)Purpose Dyspnea is highly-prevalent in lung cancer survivors following curative-intent therapy. We aimed to identify clinical determinants of dyspnea and characterize its relationship with functional exercise capacity (EC). MethodsIn an analysis of data from a cross-sectional study of lung cancer survivors who completed curative-intent therapy for stage I-IIIA disease ≥1 month previously, we tested a thorough list of comorbidities, lung function, and lung cancer characteristics. We assessed dyspnea using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer Module 13 (LC13) and functional EC the six-minute walk. We verified results with the University of California San Diego Shortness of Breath Questionnaire (SOBQ). ResultsIn 75 participants at a median of 12 months since completing treatment, the mean (SD) LC13-Dyspnea score was 35.3 (26.2); 60% had abnormally-high dyspnea. In multivariable linear regression analyses, significant clinical determinants of dyspnea were [β (95% confidence interval)]: psychiatric illness [-20.8 (-32.4, -9.09) for No/Yes], heart failure with reduced ejection fraction [-15.5 (-28.0, -2.97) for No/Yes], and forced expiratory volume in 1 second [-0.28 (-0.49, -0.06) for each % predicted]. Dyspnea was an independent predictor of functional EC [-1.54 (-2.43, -0.64) for each point]. These results were similar with the SOBQ.Conclusion

Characterization of Dyspnea in Veteran Lung Cancer Survivors Following Curative-Intent Therapy

“…12 A prospective study was recently completed which showed that dyspnea symptoms worsen at 1 to 3 mo following curative-intent lung cancer treatment. 53 As such, it is postulated that in order to maximize efforts to improve exercise, function, and QoL in lung cancer survivors following curative-intent treatment, optimizing medical therapy for cardiopulmonary disease 54 and possibly psychiatric illness 55 to alleviate dyspnea may also be important. Recent randomized controlled trials in patients with COPD have shown that combination long-acting muscarinic-antagonist and β -agonist inhaler therapy is effective in reducing dyspnea 56 and, possibly, in improving physical activity.…”