Exercise in patients with advanced non-small cell lung cancer (NSCLC): Compliance and population characteristics of patients referred to the McGill Cancer Nutrition-Rehabilitation Program (CNRP)
Bibliographic record
Abstract
8631 Background: Few studies focus on exercise in advanced NSCLC. We evaluated compliance with exercise prescription in stages 3/4 NSCLC. Methods: Patients (pts) referred to the CNRP, a multidisciplinary clinic, for weight/functional loss were evaluated for participation in a supervised exercise program. Compliance with exercise was scored as 0 (refused/home exercise), 1 (<6 sessions in 2 mo), and 2 (≥ 6 sessions in 2 mo). Gender, age, PS, stage, CRP, weight loss, and quality of life [Edmonton Syptom Assessment Scale (ESAS)] were assessed by univariate and multivariate analyses. Survival from the time of exercise prescription was calculated using the Kaplan-Meier method and compared using the log-rank test. Results: 168 pts were referred to the CNRP from April 2002 to September 2005. 92/168 (54%) were prescribed exercise. Of the 76 remaining pts, 3 (4%) refused, and 6 (8%) were on an exercise trial. Others were excluded due to bone metastasis/severe pain (50 pts, 66%), cardiovascular instability (13 pts, 17%) or poor PS (4 pts, 5%). Of the 92 who were prescribed exercise, the compliance score was 0 in 38 (41%), 1 in 37 (40%) and 2 in 17(19%). There were no significant differences in gender, age, PS, stage, ESAS, and weight loss at the time of referral among the three compliance groups. Most pts (15/17) with a compliance score of 2 were referred prior to or during initial treatment, whereas those with compliance scores of 0 and 1 were referred later in the course of treatment. Compliance with exercise correlated with survival (p<0.001). The median survival from time of exercise prescription for pts with a compliance score of 2 was 22 mo (95%CI 13.4,30.2); compared with 5 mo (95%CI 3.7,5.6) and 7 mo (95%CI 2.5,11.5) for those with compliance scores of 0 and 1 respectively. No serious adverse events occurred. Conclusion: A select group of advanced NSCLC pts can exercise safely at a moderate-high level. Those referred earlier tended to be more compliant, and their longer survival may reflect a lead time bias. Clinical trials are needed to evaluate efficacy of exercise in newly diagnosed NSCLC. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".