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The following is a summary of “Clinical effect of pulmonary rehabilitation during radiotherapy in lung cancer: A randomized controlled trial,” published in the June 2025 issue of the Lung Cancer by Lee et al.

Radiotherapy remains a cornerstone in the management of lung cancer; however, it carries a substantial risk of radiation-induced lung injury, potentially resulting in deteriorated pulmonary function, exacerbation of clinical symptoms, diminished quality of life, and adverse prognoses. As patients with impaired baseline lung function are often prioritized for radiotherapy, adjunctive therapies aimed at mitigating treatment-related pulmonary complications are essential. This study evaluated the clinical impact of an outpatient-based pulmonary rehabilitation (PR) program for patients with lung cancer undergoing radiotherapy.

A randomized controlled trial was conducted from June 2022 to May 2023. Participants were stratified based on the radiotherapy objectives and randomized into either a PR group or a control group. The outpatient PR program was administered two to three times weekly throughout the radiotherapy course. Primary and secondary outcomes included changes in exercise capacity, muscle strength, and incidence of radiation pneumonitis requiring steroid therapy.

The analysis demonstrated significant improvements in the 6-minute walking distance (6MWD) in the PR group compared with controls. Specifically, at the completion of radiotherapy, the PR group showed a mean increase of 16.9 ± 69.9 meters versus a decline of 26.1 ± 49.8 meters in the control group (P = 0.008). At one month post-radiotherapy, the improvement was 34.9 ± 39.4 meters in the PR group compared to a decline of 24.0 ± 48.3 meters in the control group (P < 0.001). At seven months post-radiotherapy, the PR group maintained a mean gain of 40.7 ± 75.7 meters, while the control group exhibited a minor reduction of 3.1 ± 47.5 meters (P = 0.043). Additionally, improvements in grip strength and other muscle mass-related parameters paralleled the gains in exercise capacity.

Importantly, the incidence of radiation pneumonitis necessitating steroid intervention was significantly lower in the PR group (9.4%) compared to the control group (54.5%) (P < 0.001), indicating a substantial protective effect associated with PR participation.

In conclusion, outpatient-based pulmonary rehabilitation administered during radiotherapy for patients with lung cancer significantly enhanced exercise capacity and markedly reduced the incidence of radiation pneumonitis requiring medical treatment. These findings advocate for the routine incorporation of structured PR programs into standard radiotherapy protocols for lung cancer to optimize patient outcomes and minimize pulmonary complications.

Source: lungcancerjournal.info/article/S0169-5002(25)00438-6/abstract