ImportanceThe Eastern Cooperative Oncology Group Performance Status (ECOG PS) is extensively used to guide treatment decisions in patients with advanced lung cancer. However, its assessment is subjective, potentially leading to discordance among observers.ObjectiveTo investigate the association between measured physical activity and ECOG PS, as well as the potential prognostic value of physical activity measurements in patients with advanced lung cancer.Design, Setting, and ParticipantsThis single-institution, prospective observational study enrolled 119 patients with advanced lung cancer scheduled to receive systemic therapy as outpatients at Matsusaka Municipal Hospital in Mie, Japan. Participants wore the wearable device amuelink (Sony) for up to 14 days to measure physical activity, including metabolic equivalent tasks, distance walked, and number of steps taken. ECOG PS was assessed at enrollment, which took place from December 2021 to August 2022.Main Outcomes And MeasuresThe primary end point was estimating the area under the curve (AUC) for classification into ECOG PS of 2 or higher using physical activity measurements. An analysis of the association with survival was also conducted.ResultsAmong the 119 patients (median [range] age, 72 (32-88) years; 71 [59.7%] male), mean distance walked (MDW) had the highest diagnostic value for classifying an ECOG PS of 2 or greater, with an AUC of 0.818 (95% CI, 0.703-0.934). Moreover, MDW was also associated with 6-month survival, with an AUC of 0.806 (95% CI, 0.694-0.918). Survival curves significantly diverged based on the MDW threshold, indicating a potential association with survival outcome (hazard ratio, 0.17; 95% CI, 0.05-0.57).Conclusions and RelevanceThe cohort study suggests that MDW, as measured by a wearable device, was associated with ECOG PS and may serve as a predictor of health status alongside ECOG PS categories. It demonstrates the potential of objectively measured physical activity in complementing subjective ECOG PS assessments in patients with advanced lung cancer. Further research is needed to confirm the prognostic value of physical activity measurements.

中文翻译：

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使用可穿戴设备进行身体活动作为晚期肺癌患者表现状态的替代方案

重要性东部肿瘤合作组表现状态 (ECOG PS) 被广泛用于指导晚期肺癌患者的治疗决策。然而，其评估是主观的，可能导致观察者之间的不一致。目的调查测量的体力活动与 ECOG PS 之间的关联，以及体力活动测量对晚期肺癌患者的潜在预后价值。设计、设置和参与者此这是一项单机构前瞻性观察性研究，纳入了 119 名晚期肺癌患者，这些患者计划在日本三重县松坂市立医院门诊接受全身治疗。参与者佩戴可穿戴设备 amuelink（索尼）长达 14 天来测量身体活动，包括代谢当量任务、步行距离和步数。 ECOG PS 在 2021 年 12 月至 2022 年 8 月期间进行的入组时进行了评估。主要终点和测量主要终点是使用体力活动测量值估计曲线下面积 (AUC)，以将 ECOG PS 分类为 2 或更高。还进行了与生存相关性的分析。 结果在 119 名患者（中位年龄 [范围] 72 (32-88) 岁；71 名 [59.7%] 男性）中，平均步行距离 (MDW) 对以下疾病的诊断价值最高：将 ECOG PS 分类为 2 或更高，AUC 为 0.818（95% CI，0.703-0.934）。此外，MDW 还与 6 个月生存相关，AUC 为 0.806（95% CI，0.694-0.918）。生存曲线根据 MDW 阈值显着分化，表明与生存结果存在潜在关联（风险比，0.17；95% CI，0.05-0.57）。结论和相关性队列研究表明，通过可穿戴设备测量的 MDW 与生存结果相关与 ECOG PS 一起，可以与 ECOG PS 类别一起作为健康状况的预测指标。它证明了客观测量的体力活动在补充晚期肺癌患者主观 ECOG PS 评估方面的潜力。需要进一步的研究来确认体力活动测量的预后价值。