Non-small Cell Lung Cancer
Conditions
Brief summary
The investigators performed a multi-centered, randomized, placebo-controlled, prospective clinical trial on the effect of comprehensive rehabilitation program to improve quality of life(QOL) and long-term survival of postoperative patients with early lung cancer. The investigators plan to enroll 236 cases in 3 years (118 cases for rehabilitation training plus traditional Chinese medicine (TCM), 118 cases for rehabilitation education plus placebo), expecting that comprehensive rehabilitation program has a better efficacy on improving QOL and long-term survival.
Detailed description
Non-Small-Cell Lung Cancer（NSCLC）is one of the malignancies with high incidence and mortality. In recent years, surgery become the preferred treatment for early stage of NSCLC. Patients with stage IA-IIIA lung cancer can undergo radical surgery, but postoperative lung cancer patients also have shortness of breath, chest pain, cough, expectoration, upper limb dysfunction and other symptoms. The symptoms seriously affect the quality of life and follow-up treatment. Comprehensive rehabilitation program may alleviate the symptoms as an effective treatment which including rehabilitation training and TCM. The investigators performed a multi-centered, randomized, placebo-controlled, prospective clinical trial on the effect of comprehensive rehabilitation program to improve quality of life(QOL) and long-term survival of postoperative patients who are not recommended for postoperative chemotherapy at stage IA and IB. Patients are randomized into observational group (rehabilitation training plus TCM), and control group (rehabilitation education plus placebo). The treatment should be last three months and the patients will be followed up regularly. The primary efficacy assessments are: (1) QOL (QLQ-LC43 scale); (2) Pulmonary function test(PFTs): 1) Forced vital capacity (FVC); 2) Forced expiratory volume in one second (FEV1); 3) Forced expiratory flow rate from 25% to 50% (FEF25-50); 4) Residual volume (RV); 5) Total lung capacity (TLC). Secondary efficacy assessments are: (1) 2 years disease-free survival; (2) TCM symptoms changes; (3) Tumer markers (CEA, CA-125 and CYFRA21-1); (4) Exercise tolerance; (5) Toxicity, side effects and security of the treatments will be assessed at the same time. The investigators plan to enroll 236 cases in 3 years (118 cases for rehabilitation training plus TCM, 118 cases for rehabilitation education plus placebo), expecting that comprehensive rehabilitation program has a better efficacy on improving QOL and long-term survival.
Interventions
Patients will be trained in one month after operation. Rehabilitation training include aerobic exercise training (using cycle ergometer for 7-14 times at all, once a day, 15-20 min/time and using treadmill for 7-14 times at all, once a day, 15-20 min/time according to the patient's endurance) and Liu Zi Jue lung exercises, which strengthen the lung function of the human body in Chinese traditional health culture, five times a week, 15 min/time.
General health education
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DRUGplacebo
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Sponsors
Shanghai Chest Hospital
Shanghai Pulmonary Hospital, Shanghai, China
Shanghai Cancer Hospital, China
Huadong Hospital
Shanghai University of Traditional Chinese Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Pathologically or cytologically confirmed stage Ia-IIIa non small cell lung cancer; * Between the ages of 18 to 75 years old; * The score of ECOG ≥2 points * Without major organ dysfunction: hemoglobin ≥10 g/dL, absolute neutrophil count (ANC) ≥1.5\*10\^9/L, platelets ≥100 \*10\^9/L; normal hepatic and renal function
Exclusion criteria
* Indefinite pathological diagnosis; * Expected survival time \< 6 months * Combined with heart, liver, kidney and hematopoietic system and other serious diseases * The patient was treated with antibiotics or infected one week before the test; * Pregnant or child breast feeding women; * Mental or cognitive disorders;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in Quality of life (QOL) | baseline, at 3 months | QOL is assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer 43 (EORTC QLQ-LC43). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total lung capacity（TLC） | after intervention at 2 weeks | TLC is measured in a test known as Lung valume(LV)spirometry,a type of pulmonary function test.TLC equals the vital capacity plus the residual capacity. |
| Forced vital capacity (FVC) | after intervention at 2 weeks | FVC is the volume of air exhaled with maximum effort and speed after a full inspiration. FVC is measured in a test known as spirometry, a type of pulmonary function test. |
| Forced expiratory volume in one second(FEV1) | after intervention at 2 weeks | FEV1 is an individual test measure used to assess limitations in airflow, a type of pulmonary function test,which measures the amount of air exhaled in onesecond. |
| Maximum mid expiratory flow(MMEF) | after intervention at 2 weeks | MMEF is forced expiratory flow between 25% and 75% of forced vital capacity,a type of pulmonary function test. |
| Residual capacity (RV) | after intervention at 2 weeks | RV is measured in a test known as Lung valume(LV)spirometry,a type of pulmonary function test.RV is the volume of air remaining in the lungs after a maximal expiratory effort. |
| TCM symptoms changes | after intervention at 3 months | TCM symptoms changes are according to the lung cancer symptom classification quantization table in Guiding Principles for Clinical Research of Traditional Chinese Medicine in the Treatment of Lung Cancer (2002 Edition) |
| Tumor markers | after intervention at 3 months | Tumor markers include CEA, CA-125 and CYFRA21-1 |
| Safety assessment evaluated according to Common Toxicity Criteria | after intervention at 3 months | Safety assessment is evaluated according to Common Toxicity Criteria (CTC 3.0) |
| Disease-free survival (DFS) | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 60 months | Time from randomization to first recurrence or metastasis |
Countries
China
Outcome results
None listed