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bioRxiv · 10.1101/508440

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

Ha, D.·Ries, A. L.
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Abstract

PurposeDyspnea 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).\n\nMethodsIn 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).\n\nResultsIn 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 [{beta} (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.\n\nConclusionWe identified clinical determinants of dyspnea which have pathophysiological bases. Dyspnea was independently associated with functional EC. Behavioral interventions to promote exercise in lung cancer survivors following curative-intent therapy may need to also optimize medical therapy for cardiopulmonary and/or psychiatric disease and reduce dyspnea to be effective.

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Ha, D., Ries, A. L.. 2018-12-31. Characterization of Dyspnea in Lung Cancer Survivors Following Curative-Intent Therapy. https://doi.org/10.1101/508440

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