Conectar
Radiotherapy (RT) can cause a range of negative impacts in addition to the intended treatment impacts. Pulmonary rehabilitation (PR) may improve the physical and psychological conditions of patients with lung cancer receiving RT, but specific evidence is lacking. This review mapped the evidence on PR in patients with lung cancer receiving RT for intervention characteristics and outcome assessments.
PubMed, EMBASE, CINAHL, Proquest, Web of Science, CNKI and WanFang were searched for studies from January 2003 to April 2025.
We included randomised controlled trials and non-randomised comparative intervention studies that included centre-based PR in patients ≥18 years with lung cancer who were receiving RT. PR was defined as any type of exercise, respiratory training, or both and/or at least one additional component (eg, psychological support). Studies were excluded if they were not available in English, were not full-text articles or were non-peer-reviewed.
Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data. PR components and the typology of outcome assessments used were mapped at the final data synthesis level.
Out of 3120 records, nine studies were investigated in the final data synthesis. In these studies, in addition to exercise or respiratory training, psychological support and disease education were the most common components of PR. Pulmonary function, quality of life, symptom assessment and exercise performance were commonly assessed outcomes in these included studies. Although the effectiveness of PR is difficult to synthesise, the evidence for improvements in exercise performance and symptoms of dyspnoea and anxiety/depression is promising.
Evidence on PR in patients with lung cancer receiving RT is sparse, and there is a heterogeneous understanding of PR. The development of standardised PR protocols and investigation of the capabilities of PR in this growing and under-represented patient population are essential.
The effect of prehabilitation on reducing the level of postoperative stress and facilitating recovery has been proven to be controversial in previous studies involving patients with cancer. This review contributes to the improvement of an intervention programme by qualitatively integrating the prehabilitation experiences of patients with cancer.
This review aimed to integrate the individual experiences of patients with cancer who had received prehabilitation interventions to identify the barriers and facilitators to implementation, which can be used to understand patients' adherence behaviours.
This was a qualitative evidence synthesis review.
Articles were systematically searched from inception to February 18, 2025, using four English databases and three Chinese databases. Keywords and Medical Subject Headings were used to identify potential studies written in both Chinese and English. This study was performed using the Joanna Briggs Institute qualitative systematic review methodology.
Twenty-five articles were included in this review. Guided by the Theoretical Domains Framework (TDF), eight synthesised findings were extracted, focusing on the representation of factors influencing the adherence of patients with cancer to prehabilitation, including the domains of knowledge (two facilitators), reinforcement (two facilitators), beliefs about consequences (two facilitators), beliefs about capabilities (two barriers), environmental context and resources (two barriers, one intervention preference factor), social influence (one facilitator, one intervention preference factor), emotion (one barrier, one facilitator) and behavioural regulation (one facilitators, two intervention preference factors).
Our findings indicate that the adherence to prehabilitation among patients with cancer is shaped by a dynamic interplay of determinants. Structured assessments, self-monitoring, tailored interventions and tele-prehabilitation can improve patients' self-efficacy, perceived benefits and access to resources, which in turn can facilitate their completion of prehabilitation.
This study deepens our understanding of behaviours related to adherence to prehabilitation among patients with cancer and provides valuable guidance for the formulation and optimisation of subsequent prehabilitation intervention programmes.
ENTREQ.
No patient or public contributions.
PROSPERO CRD: 42024553972
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