Research progress on pulmonary rehabilitation in lung cancer: From clinical application to technological innovation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Shujun ¹ , LAI Yutian ^2,3 ,  CHE Guowei ^2,3

1. The Third Clinical College of Xinxiang Medical University, Xinxiang, 453003, P. R. China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
3. Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

CHE Guowei, Email: cheguoweixw@126.com

Keywords：

Lung Cancer; pulmonary rehabilitation; clinical application; review

DOI：

10.7507/1007-4848.202503020

Video：

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Abstract Full text Figures/Tables Video References Cited by

[Abstract]Lung cancer exhibits the highest incidence and mortality rates among malignancies in China. As a critical component of comprehensive lung cancer management, pulmonary rehabilitation (PR) has emerged as a prominent research focus. PR employs multimodal interventions to improve functional capacity and quality of life in lung cancer patients, with applicability across all disease stages. However, challenges persist, including the lack of standardized protocols, uncertainty regarding optimal implementation timing, and suboptimal patient adherence. Technological innovations hold significant potential, and future efforts should prioritize personalized regimens and optimized interventions to advance its widespread clinical adoption.

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2. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
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4. Zhao L, Ma L, Chen X, et al. Psychological nursing intervention improve the mental health status of young patients with lung cancer surgery during the perioperative period. Medicine (Baltimore), 2021, 100(31): e26736.
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7. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-e64.
8. Fuzhi Y, Dongfang T, Wentao F, et al. Rapid recovery of postoperative pulmonary function in patients with lung cancer and influencing factors. Front Oncol, 2022, 12: 927108.
9. Zhou N, Ripley-Gonzalez JW, Zhang W, et al. Preoperative exercise training decreases complications of minimally invasive lung cancer surgery: A randomized controlled trial. J Thorac Cardiovasc Surg, 2025, 169(2): 516-528.
10. Olivier C, Grosbois JM, Cortot AB, et al. Real-life feasibility of home-based pulmonary rehabilitation in chemotherapy-treated patients with thoracic cancers: A pilot study. BMC Cancer, 2018, 18(1): 178.
11. Zhou C, Qin Y, Zhao W, et al. International expert consensus on diagnosis and treatment of lung cancer complicated by chronic obstructive pulmonary disease. Transl Lung Cancer Res, 2023, 12(8): 1661-1701.
12. Lung Cancer Specialty Committee of Chinese Elderly Health Care Association. Chinese expert consensus on perioperative pulmonary rehabilitation training for lung cancer. Zhongguo Fei Ai Za Zhi, 2024, 27(7): 495-503.
13. Franklin BA, Eijsvogels TMH, Pandey A, et al. Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the ASPC Part Ⅰ: Bioenergetics, contemporary physical activity recommendations, benefits, risks, extreme exercise regimens, potential maladaptations. Am J Prev Cardiol, 2022, 12: 100424.
14. Ficarra S, Kang DW, Wilson RL, et al. Exercise medicine for individuals diagnosed with Lung Cancer: A systematic review and meta-analysis of health outcomes. Lung Cancer, 2025, 201: 108413.
15. Cruz Mosquera FE, Murillo SR, Naranjo Rojas A, et al. Effect of exercise and pulmonary rehabilitation in pre- and post-surgical patients with lung cancer: Systematic review and meta-analysis. Medicina (Kaunas), 2024, 60(11): 1725.
16. Lai Y, Dong Y, Tian L, et al. The optimal time of high-intensity pre-rehabilitation for surgical lung cancer patients: A retrospective cohort study with 4452 patients. Ann Surg Oncol, 2025, 32(1): 265-273.
17. Nguyen T, Tracy K, Ullah A, et al. Effect of exercise training on quality of life, symptoms, and functional status in advanced-stage lung cancer patients: A systematic review. Clin Pract, 2023, 13(3): 715-730.
18. Messaggi-Sartor M, Marco E, Martínez-Téllez E, et al. Combined aerobic exercise and high-intensity respiratory muscle training in patients surgically treated for non-small cell lung cancer: A pilot randomized clinical trial. Eur J Phys Rehabil Med, 2019, 55(1): 113-122.
19. Zhong J, Trinh I, Raju S, et al. Pulmonary rehabilitation in patients with operable non-small cell lung cancer. J Clin Med, 2025, 14(3): 770.
20. Sakai Y, Yamaga T, Yamamoto S, et al. Effects and usefulness of inspiratory muscle training load in patients with advanced lung cancer with dyspnea. J Clin Med, 2023, 12(10): 3396.
21. Templeman L, Roberts F. Effectiveness of expiratory muscle strength training on expiratory strength, pulmonary function and cough in the adult population: A systematic review. Physiotherapy, 2020 Mar: 106: 43-51.106-143.
22. Ammous O, Feki W, Lotfi T, et al. Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev, 2023, 1(1): CD013778.
23. Burge AT, Gadowski AM, Jones A, et al. Breathing techniques to reduce symptoms in people with serious respiratory illness: A systematic review. Eur Respir Rev, 2024, 33(174): 240012.
24. Purushotham A, Bains S, Lewison G, et al. Cancer and mental health: A clinical and research unmet need. Ann Oncol, 2013, 24(9): 2274-2278.
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26. van Tuijl LA, Basten M, Pan KY, et al. Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis. Cancer, 2023, 129(20): 3287-3299.
27. Lei F, Lee E, Shin J, et al. Non-pharmacological interventions on anxiety and depression in lung cancer patients' informal caregivers: A systematic review and meta-analysis. PLoS One, 2023, 18(3): e0282887.
28. Liu CA, Liu T, Li HC, et al. Nutrition impact symptoms: Noteworthy prognostic indicators for lung cancer. Clin Nutr, 2023, 42(4): 550-558.
29. Polański J, Świątoniowska-Lonc N, Kołaczyńska S, et al. Diet as a factor supporting lung cancer treatment-A systematic review. Nutrients, 2023, 15(6): 1477.
30. Chai BS, Ingledew PA. Assessment of lung cancer YouTube videos for patient education. J Cancer Educ, 2023, 38(5): 1760-1766.
31. Saab MM, O'Driscoll M, FitzGerald S, et al. Primary healthcare professionals' perspectives on patient help-seeking for lung cancer warning signs and symptoms: A qualitative study. BMC Prim Care, 2022, 23(1): 119.
32. Triplette M, Wenger DS, Shahrir S, et al. Patient identification of lung cancer screening follow-up recommendations and the association with adherence. Ann Am Thorac Soc, 2022, 19(5): 799-806.
33. Granger C, Cavalheri V. Preoperative exercise training for people with non-small cell lung cancer. Cochrane Database Syst Rev, 2022, 9(9): CD012020.
34. Goldsmith I, Chesterfield-Thomas G, Toghill H. Pre-treatment optimization with pulmonary rehabilitation in lung cancer: Making the inoperable patients operable. EClinicalMedicine, 2020, 31: 100663.
35. Lai Y, Wang X, Zhou K, et al. Impact of one-week preoperative physical training on clinical outcomes of surgical lung cancer patients with limited lung function: A randomized trial. Ann Transl Med, 2019, 7(20): 544.
36. Guo Y, Pan M, Xiong M, et al. Efficacy of preoperative pulmonary rehabilitation in lung cancer patients: A systematic review and meta-analysis of randomized controlled trials. Discov Oncol, 2025, 16(1): 56.
37. Wang J, Deng N, Qi F, et al. The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: A systematic review and meta-analysis. BMC Pulm Med, 2023, 23(1): 276.
38. Zhang Z, Mostofian F, Ivanovic J, et al. All grades of severity of postoperative adverse events are associated with prolonged length of stay after lung cancer resection. J Thorac Cardiovasc Surg, 2018, 155(2): 798-807.
39. Su XE, Hong WP, He HF, et al. Recent advances in postoperative pulmonary rehabilitation of patients with non-small cell lung cancer (Review). Int J Oncol, 2022, 61(6): 156.
40. Cavalheri V, Burtin C, Formico VR, et al. Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database Syst Rev, 2019, 6(6): CD009955.
41. Flores AM, Shah M, Bedjeti K, et al. Risk of significant functional impairment across cancer diagnosis and care continuum. Cancer, 2025, 131(1): e35571.
42. Do J, Lee SH, Kim SA, et al. The effects of inspiratory muscle training with pulmonary rehabilitation on NSCLC patients during radiation therapy: A pilot clinical study. Thorac Cancer, 2023, 14(17): 1567-1573.
43. Li Q, Guo C, Cao B, et al. Safety and efficacy evaluation of personalized exercise prescription during chemotherapy for lung cancer patients. Thorac Cancer, 2024, 15(11): 906-918.
44. Lee J. Physiologic and psychologic adaptation to exercise interventions in lung cancer patients undergoing chemotherapy: A systematic review and meta-analysis of randomized controlled trials. Support Care Cancer, 2021, 29(6): 2863-2873.
45. Peddle-McIntyre CJ, Singh F, Thomas R, et al. Exercise training for advanced lung cancer. Cochrane Database Syst Rev, 2019, 2(2): CD012685.
46. Ester M, Culos-Reed SN, Abdul-Razzak A, et al. Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer. BMC Cancer, 2021, 21(1): 159.
47. Tatematsu N, Naito T, Okayama T, et al. Development of home-based resistance training for older patients with advanced cancer: The exercise component of the nutrition and exercise treatment for advanced cancer program. J Geriatr Oncol, 2021, 12(6): 952-955.
48. Quist M, Langer SW, Lillelund C, et al. Effects of an exercise intervention for patients with advanced inoperable lung cancer undergoing chemotherapy: A randomized clinical trial. Lung Cancer, 2020, 145: 76-82.
49. Mikkelsen MK, Lund CM, Vinther A, et al. Effects of a 12-week multimodal exercise intervention among older patients with advanced cancer: Results from a randomized controlled trial. Oncologist, 2022, 27(1): 67-78.
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Latest ArticlesResearch progress on pulmonary rehabilitation in lung cancer: From clinical application to technological innovation

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