Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
Pulmonary Rehabilitation Before Lung Cancer Resection
This is a study funded by the National Institute of Health. The rationale for the need of this research is the lack of any well proven risk-reducing intervention that may decrease the morbidity of lung cancer resection in patients with COPD or that may improve their quality of life trajectory, a meaningful outcome in the overall disease progression. The proposed intervention is unique as it combines exercise and behavioral interventions that were pilot tested in a randomized single-blinded controlled design in the proposed population and proved feasible and potentially effective. The aim is to test the effect of the proposed rehabilitation on length of stay, pulmonary complications and quality of life trajectory.
Prospectively, 194 patients will be randomized to either ten sessions of preoperative
pulmonary rehabilitation (PR) vs. standard care at a number of healthcare centers throughout
the United States. This study will be open for 36 months. Randomization will be stratified by
three variables: very severe lung function (yes vs. no), prior neo-adjuvant chemotherapy for
this operation (yes vs. no) and open thoracotomy vs. video assisted thoracoscopy. The primary
and secondary objectives are provided below.
Primary Objective:
To prospectively determine the effect of 10 sessions of customized preoperative PR on the
length of hospital stay in patients that undergo a lung cancer resection and have COPD
compared to a matched control group. Hypothesis: Ten sessions of customized preoperative PR
will significantly reduce the length of hospital stay.
Secondary Objectives:
1. To prospectively determine the effect of 10 sessions of customized preoperative PR on
the number of postoperative complications in patients that undergo a lung cancer
resection and have COPD compared to a matched control group.
- Hypothesis: Ten sessions of customized preoperative PR will significantly reduce
the number of postoperative pulmonary complications.
2. To prospectively determine the effect of a 10-session preoperative PR on the trajectory
of quality of life at 3 and 6 months after the curative resection compared to a matched
control group.
- Hypothesis: Ten sessions of customized preoperative PR will significantly and
meaningfully (more than the minimal clinically important difference) improve
quality of life after surgery compared to a control group.
Patients will be followed at 3 and 6 months post-surgery.
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