Feasibility of an early versus delayed rehabilitation intervention in patients with lung cancer on cancer-related fatigue: a pilot RCT

Background: Cancer-related fatigue (CRF) reduces physical performance and quality of life (QoL). Some authors suggest including moderate-intensity physical exercise to manage CRF; however, the optimal timing to offer rehabilitation remains unclear. The primary aim is to investigate the feasibility of a pulmonary rehabilitation (PR) program, including physical exercise and educational sessions, for lung cancer patients undergoing cancer treatments; secondary objectives are to investigate its effect on CRF, physical performance, and QoL. Methods: This randomized controlled trial enrolls 40 patients with stage II or III non-small-cell lung cancer undergoing chemotherapy, radiotherapy, or immunotherapy. Patients are randomly assigned to one of two groups: Group A (early-PR) begins PR after enrollment, at the beginning of non-surgical therapies, while Group B (delayed-PR) begins PR for 3 months after enrollment. The PR program consists of two education sessions focused on CRF management and eight supervised exercise sessions, including aerobic, strengthening, stretching, and breathing exercises, combined with home exercises. CRF, QoL, activity level, and endurance are assessed at the baseline (T0) and at 3 and 6 months (T1-T2). One year after T0, survival is assessed along with the CRF, QoL, and activity level (T3). Feasibility will be assessed at 3 and 6 months.