Effect of nutritional habits and physical activity on treatment response and survival in lung cancer patients

Aim Lung cancer is a type of cancer with low treatment response and survival despite all advances in diagnosis and treatment methods. Although numerous factors influence treatment response and survival in lung cancer, there is limited data on the effects of nutritional habits and physical activity on treatment. The aim of this study was to investigate the effects of nutritional habits and physical activity levels of patients diagnosed with advanced non-small cell lung cancer (NSCLC) on response to chemotherapy treatment and survival. Materials and Methods Patients diagnosed with stage 4 NSCLC for the first time in our clinic between 05.01.2023 and 05.07.2023, with an ECOG performance score of 2 or below, and planned to get platinum-based chemotherapy as their first treatment protocol were included in the study. The patients' age, gender, height, weight, body mass index, education level, profession, region of residency, concomitant conditions, pathological diagnosis, metastatic sites, smoking history, and ECOG performance scores were all recorded. At the start of treatment, the patients' nutritional habits, physical activity levels, and quality of life were assessed using the "Mediterranean Diet Adherence Screener," "24-Hour Food Consumption Record," "International Physical Activity Questionnaire," "Food Consumption Frequency Form," and "Healthy Lifestyle Behavior Scale". The average number of steps taken by patients over a seven-day period was calculated. The association between the patients' nutritional habits, physical activity levels, and quality of life with treatment response, treatment-related side effects, survival at the end of 6 months, and progression-free survival was investigated. Results A total of 37 patients, 35 of whom were male, were included in the study. The average age of the patients was 63.49. The 6-month survival rate of the patients was 81.1% and the progression-free survival rate was 62.2%. Considering the treatment responses, there was progression in 35.1% of the patients, partial regression in 54.1%, and complete regression in 8.1%. There was no association established between the patients' age and body mass index and their 6-month survival rate. No significant relationship was found between the pathological diagnosis of the patients and 6-month survival, progression-free survival and treatment responses. Six-month survival was found to be significantly higher in minimally physically active patients than in inactive patients (p: 0.022). Six-month survival was found to be significantly higher in patients who adhered to the Mediterranean diet compared to patients who did not comply with the Mediterranean diet (p: 0.019). However, no significant relationship was found between treatment response and progression-free survival and Mediterranean diet compliance and physical activity level. There was not a significant association between food consumption frequency and healthy life scores and treatment response and progression-free survival. Patients who adhere to the Mediterranean diet had considerably decreased rates of chemotherapy-related gastrointestinal system side effects (p<0.001). Conclusion It was shown in our study that physical activity and a Mediterranean-style diet were beneficial for both the development of chemotherapy side effects and 6-month survival. However, their effects on treatment response and progression-free survival could not be demonstrated. The Mediterranean diet can be safely recommended for lung cancer patients undergoing chemotherapy and experiencing several gastrointestinal system symptoms. Encouraging individuals diagnosed with lung cancer to increase their physical activity levels may be beneficial during the treatment process. Key words: lung cancer, Mediterranean diet, physical activity