ESTRO 2024 - Abstract Book

S1601

Clinical - Lung

ESTRO 2024

381 patient referrals to the P4C service during the screening period met inclusion criteria. 84% (n= 279/331) of patients successfully contacted by telephone underwent a first assessment. 86% (n= 245/279) of completed first assessments took place within seven days of referral. Twenty-seven patients were assessed as not medically suitable for the P4C programme. In total, 155 patients completed the prehab4cancer programme (40.6%, intention to-treat). This included a median of 6 prescribed exercise sessions completed (IQR 2.5 – 11). Patients had a median of 28 days (IQR 21 – 39) from referral to P4C to starting oncology treatment. Of those referred to the P4C programme, median age was 74 (IQR 68 – 79), with 51% male (n = 194/381). 91% of patients initially referred (n = 342/374) to P4C started radical intent non-surgical treatment for cancer (n = 15 nil treatment, n = 18 palliative intent therapy). Of those starting radical treatment, median performance status at referral was 1 (IQR 1- 1). Diagnosis was 69% NSCLC (n = 236/342), 5% Small Cell (n = 14/342) and 27% radiological diagnosis (n= 92/342). Patients had a median Forced Vital Capacity (% Predicted) of 91 (IQR 77-106) and Diffusing Capacity for Carbon Monoxide (% Predicted) of 56 (IQR 44-69). Radiotherapy was delivered as ≤ 8 # (41%, n = 139/341), 15 -20 # in 50-60 Gy (44%, n = 152/341), 30-33 # in 60-66Gy (12%, n = 41/341), and other (3%, n = 9 / 341). 20% (n = 72/342) of patients underwent treatment that included chemotherapy (n = 43 concurrent, n = 29 sequential).

In those starting radical radiotherapy, there was no significant difference in gender, age, lung function or clinical frailty score, between those completing the P4C programme vs not.

On completing the P4C program functional physiology showed a significant improvement. 6MWT (n paired = 31, +31.4 (95% CI 23.3 – 39.5), p < 0.001), STS (n paired = 52, +2.9 (95% CI 2.1 – 3.6), p < 0.001). Quality of life measures also significantly improved. WHODAS (n paired = 126, -2.5 (95% CI -3.0 - -2.0), p < 0.001), SEE (n paired = 120, +11, (95% CI 9.0 – 14), p < 0.001), EQ-5D-5L (n paired = 126, +0.05 (95% CI 9.0 – 14), p < 0.001) and IPAQ (n paired = 126, p < 0.001).

There was no significant difference between groups in incidence of CTCAE grade 2 or higher toxicity, or 90 & 365 day mortality.