Association between physical activity and health-related quality of life: time to deterioration model analysis in lung adenocarcinoma

Effect of physical activity on patients of NSCLC

OBJECTIVE

The purpose of this study is to assess the impact of physical activity on both therapeutic efficacy and immune-related adverse events (irAEs) during immunotherapy for non-small cell lung cancer (NSCLC).

METHODS

Physical activity was divided into three groups: light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA) for laboratory indexes, efficacy, and irAEs. A multivariate logistic regression was employed to analyze the relationship between sedentary behavior with efficacy and irAEs.

RESULTS

The study included 121 patients. The three levels of physical activity were not significantly associated with efficacy or irAEs. However, noteworthy disparities were observed in base-hemoglobin levels (F = 3.4, P = 0.037) and base-lymphocyte levels (χ2 = 6.13, P = 0.047) among the three groups. After treatment, we identified statistically significant variations in albumin levels (P = 0.012) and lymphocyte counts (P = 0.035). Furthermore, a negative correlation emerged between pre-treatment sedentary behavior duration and immune-efficacy (β: -0.005, P = 0.027).

CONCLUSIONS

In summary, within the cohort of NSCLC patients undergoing single immunotherapy or a combination of immunotherapy and chemotherapy, physical activity is closely related to immune and inflammatory indicators in patients, and prolonged sitting will reduce the therapeutic effect.

Clinical efficacy of iodine-125 radioactive particle implantation with deep hyperthermia in malignant tumor treatment: A retrospective analysis

Purpose

In the current study, the clinical efficacy of iodine-125 (125I) radioactive particle implantation with deep hyperthermia in malignant tumor treatment was retrospectively analyzed.

Material and methods

Sixty patients with malignant tumors treated at Zhongshan Hospital affiliated with Dalian University, from January 2021 to January 2023, were included in this retrospective analysis. Computed tomography (CT)-guided 125I radioactive particles were implanted into lesions, followed by deep hyperthermia administered for 3 days after surgery. Lesion size was evaluated monthly using CT or magnetic resonance imaging (MRI), and objective response rate (ORR) and local control rate (DCR) were calculated. Mean pain numerical score and European Organization for Research and Treatment of Cancer quality of life core scale C30 (EORTC QLQ-C30 v. 3.0) were assessed pre-treatment and post-treatment, and post-operative adverse reactions were comparatively analyzed.

Results

After 6 months, the combined treatment resulted in a 73.33% ORR and an 81.67% DCR among 60 patients experiencing pre-treatment pain, and 49 (81.67%) exhibited effective pain relief. EORTC QLQ-C30 v. 3.0 evaluation revealed improved quality of life post-treatment. Adverse reactions during combined treatment were mitigated with targeted supportive measures, and no adverse reactions of level 2 or higher were observed.

Conclusions

125I radioactive particle implantation with deep hyperthermia is shown to be an effective combination therapy for malignant tumors, yielding significant clinical efficacy. Notably, it enhances patient quality of life, reduces tumor burden, mitigates adverse reactions, and alleviates pain. Given its minimal trauma and mild adverse reactions, this combination therapy warrants widespread clinical application.

Physical activity and pain in people with cancer: a systematic review and meta-analysis

PURPOSE

Physical activity can provide analgesic benefit but its effect on cancer-related pain is unclear. This review synthesised and appraised the evidence for the effect of physical activity on pain in people living with or beyond cancer.

METHODS

A systematic search of Ovid Medline and Embase was performed to identify randomised controlled trials (RCTs), randomised cross-over studies (RXTs), and prospective observational studies that examined physical activity and pain outcomes in adults living with or beyond cancer. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the GRADE system was used to assess evidence quality.

RESULTS

One hundred twenty-one studies (n = 13,806), including 102 RCTs, 6 RXTs, and 13 observational studies, met the criteria for inclusion. Meta-analyses of RCTs identified a decrease in pain intensity (n = 3734; standardised mean difference (SMD) - 0.30; 95% confidence interval (CI) - 0.45, - 0.15) and bodily pain (n = 1170; SMD 0.28; 95% CI 0.01, 0.56) but not pain interference (n = 207; SMD - 0.13, 95% CI - 0.42, 0.15) following physical activity interventions. Individual studies also identified a reduction in pain sensitivity but not analgesic use, although meta-analysis was not possible for these outcomes. High heterogeneity between studies, low certainty in some effect estimates, and possible publication bias meant that evidence quality was graded as very low to low.

CONCLUSION

Physical activity may decrease pain in people living with and beyond cancer; however, high heterogeneity limits the ability to generalise this finding to all people with cancer or to specific types of cancer-related pain.