Purpose

Maximal cardiopulmonary exercise testing (max. CPET) provides the most accurate measurement of cardiorespiratory fitness. However, glioblastoma (GBM) patients often undergo less intensive tests, e.g., 6-min walk test or self-rating scales. This study aims to demonstrate feasibility and safety of max. CPET in GBM patients, concurrently evaluating their physical fitness status.

Methods

Newly diagnosed GBM patients undergoing adjuvant chemotherapy were offered participation in an exercise program. At baseline, max. CPET assessed cardiorespiratory fitness including peak oxygen consumption (VO₂peak), peak workload, and physical work capacity (PWC) at 75% of age-adjusted maximal heart rate (HR). Criteria for peak workload were predefined based on threshold values in HR, respiratory quotient, respiratory equivalent, lactate, and rate of perceived effort. Data were compared to normative values. Adverse events were categorized according to standardized international criteria. Further, self-reported exercise data pre- and post-diagnosis were gathered.

Results

All 36 patients (median-aged 60; 21 men) met the predefined criteria for peak workload. Mean absolute VO₂peak was 1750 ± 529 ml/min, peak workload averaged 130 ± 43 W, and mean PWC was 0.99 ± 0.38 W/kg BW, all clinically meaningful lower than age- and sex-predicted normative values (87%, 79%, 90%, resp.). Only once (3%) a minor, transient side effect occurred (post-test dizziness, no intervention needed). Self-reported exercise decreased from 15.8 MET-h/week pre-diagnosis to 7.2 MET-h/week post-diagnosis.

Conclusion

Max. CPET in this well-defined population proved feasible and safe. GBM patients exhibit reduced cardiorespiratory fitness, indicating the need for tailored exercise to enhance health and quality of life. CPET could be essential in establishing precise exercise guidelines.

中文翻译：

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接受化疗的胶质母细胞瘤患者的最大心肺运动试验：评估可行性、安全性和身体健康状况

目的

最大心肺运动测试（最大 CPET）可提供最准确的心肺健康测量。然而，胶质母细胞瘤（GBM）患者经常接受强度较低的测试，例如6分钟步行测试或自评量表。本研究旨在证明最大的可行性和安全性。对 GBM 患者进行 CPET，同时评估其身体健康状况。

方法

接受辅助化疗的新诊断 GBM 患者可以参加锻炼计划。在基线处，最大值CPET 评估心肺健康状况，包括峰值耗氧量（VO ₂峰值）、峰值工作负荷和年龄调整最大心率 (HR) 75% 时的体力工作能力 (PWC)。峰值工作量的标准是根据心率阈值、呼吸商、呼吸当量、乳酸和感知努力率预先确定的。将数据与标准值进行比较。不良事件根据标准化国际标准进行分类。此外，还收集了诊断前和诊断后自我报告的运动数据。

结果

所有 36 名患者（中位年龄 60 岁；21 名男性）均符合峰值工作量的预定标准。平均绝对 VO ₂峰值为 1750 ± 529 ml/min，峰值工作量平均为 130 ± 43 W，平均 PWC 为 0.99 ± 0.38 W/kg BW，所有临床意义均低于年龄和性别预测的规范值（87%，分别为 79%、90%）。仅一次 (3%) 发生轻微、短暂的副作用（测试后头晕，无需干预）。自我报告的运动量从诊断前的 15.8 MET-h/周减少到诊断后的 7.2 MET-h/周。

结论

最大限度。事实证明，CPET 在这一明确人群中是可行且安全的。 GBM 患者的心肺健康状况较差，表明需要进行针对性的锻炼来增强健康和生活质量。 CPET 对于建立精确的运动指南至关重要。