Is exercise training useful in advanced lung cancer patients?

Lung cancer is one of the most common cancers worldwide, considering that there are more than 1.6 million new cases per year. Both disease severity and complexity and the indirect effects of its treatment might lead patients to become less fit. 
Exercise training is defined as “a subset of physical activity that is planned, structured, and repetitive and that has as a final or an intermediate objective the improvement or maintenance of physical fitness.” Exercise training has been demonstrated to improve both exercise capacity and quality of life in cancer survivors. However, its specific effects in people with advanced lung cancer are not yet clear.
Therefore, the aim of this Cochrane Systematic Review was to investigate the effects of exercise training on exercise capacity in adults with advanced lung cancer. Secondary aims included effects on quality of life, dyspnoea, fatigue, anxiety and depression, lung functioning, level of physical activity, adverse events, performance status, body weight, and overall survival.
Exercise capacity can be measured in different ways, such as the 6 minutes walking test or the peak of oxygen uptake during a maximal incremental cardiopulmonary exercise test. 
The Review included 6 randomised controlled trials involving 221 participants. Evidence demonstrated that, on completion of the intervention period, both exercise capacity and disease-specific, global, health-related quality of life were significantly improved in the intervention group than in controls, while there were no significant differences in the other investigated outcomes.
Considering the low quality and the scarcity of available evidence, larger high-quality randomised controlled trials should be conducted to confirm the current findings. Moreover, safety and feasibility should be investigated as well.

Comment by Francesco Agostini