Identifikation funktioneller Erfolgsmaße und Ermittlung von Prädiktoren für ein hohes Reha-Outcome bei Patienten mit Bronchialkarzinom

Das Bronchialkarzinom stellte im Jahr 2004 die häufigste Krebsneuerkrankung in Europa dar. Die Mortalität konnte trotz innovativer Behandlungsmethoden, die sich zum Beispiel durch den Einsatz der Tyrosinkinasehemmer ergeben haben, nicht entscheidend gesenkt werden. Aufgrund fehlender Screeningmethod...

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Bibliographic Details
Main Author: Riesenberg, Hendrik
Contributors: Lübbe, Andreas Stephan (Professor Dr. Dr.) (Thesis advisor)
Format: Dissertation
Published: Philipps-Universität Marburg 2007
Innere Medizin
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Table of Contents: Rationale: 1. Does a standardized submaximal aerobic endurance training improve physiological parameters and quality of life after surgery/radiation therapy against lung cancer? 2. To find out if there was a correlation among the patients´ quality of life and their physical performance. Methods: 45 patients with lung cancer (WHO I-III after surgery and/or radiation treatment) entered a 28-day in-patient rehabilitation programme consisting of a standardized aerobic training programme (submaximal interval training on bicycle ergometer daily, 6 times a week, 30 min., heart rate adjusted). Functional status and the health-related quality of life as well as quality of life (QLQ-C30, QLQ-LC13, SF-36 and MFI-20) were examined at the beginning, within the rehab stay and at day 28. Results: A substantial increase of work performance (bicycle ergometry and the six-minute walking test) could be noticed. Pulmonary function (FEV1, FVC) and haemoglobin rose significantly. Also, heart rates at rest could be reduced and the heart rate variability (measure of efficacy of endurance training) could be raised significantly. Moreover, health-related quality of life significantly improved and fatigue declined. Although total quality of life was low, there were significant positive correlations between quality of life, the extent of fatigue and functional parameters (6-minute walking distance, bicycle performance as well as FEV1 and FVC). In addition, there were no age- or gender-dependent correlations with physical performance, quality of life and the extent of fatigue. Good motivation however, was found to be a predictor for a high rehabilitation outcome. Summary: Taken together, a standardized aerobic endurance training improves physiological and psychological parameters after surgery and/or radiation treatment for lung cancer. Future studies will compare this programme against a control group over a 6-month period.