肺癌是全球范围内发病率和死亡率最高的恶性肿瘤之一,严重威胁人类健康。 近年来,运动疗法作为一种非药物 干预手段,在肺癌的预防、治疗及康复过程中展现出显著效果。 临床研究表明,运动疗法能够有效改善肺癌患者的心肺功 能,提高峰值摄氧量和 6 分钟步行测试表现,从而缓解术后呼吸困难并增强体力。 此外,运动疗法可提升患者的肌肉质量和运 动能力,减少肌肉减少症的发生,并降低术后并发症(如肺炎、肺不张)的风险,进而缩短住院时间,提高生存质量。 在机制层 面,运动疗法通过多种途径影响肺癌进展。 首先,运动疗法能够调节肿瘤微环境(TME),促进免疫细胞(如 CD8 + T 细胞)浸 润,并可能使“免疫荒漠型”或“免疫排斥型”TME 向“免疫炎症型”转变,增强抗肿瘤免疫反应。 其次,运动疗法可影响肿瘤血 管生成,改善肿瘤缺氧状态,并调节血管内皮生长因子等关键因子的表达。 最后,运动疗法还能促进肺癌细胞凋亡,如上调抑 癌基因 p53 的表达,激活 BAX/ BAK-caspase-3 凋亡通路,从而抑制肿瘤生长。 然而,不同运动方式(如耐力运动与高强度间歇 训练)对免疫微环境的影响存在差异,具体机制仍需进一步研究。 运动疗法在肺癌管理中展现出显著临床价值,不仅改善患 者生理功能与生活质量,亦通过免疫调节及促凋亡机制协同强化抗肿瘤效应。 本文旨在对运动疗法的临床效果以及作用机 制进行概述。

Lung cancer is one of the most prevalent and lethal malignancies worldwide posing a significant threat to human health. In recent years exercise therapy has emerged as a promising non-pharmacological intervention for the prevention treatment and rehabilitation of lung cancer. Clinical studies demonstrate that exercise effectively improves cardiopulmonary function in lung cancer patients enhancing peak oxygen uptake and 6-minute walk test performance thereby alleviating postoperative dyspnea and increasing physical endurance. Additionally exercise enhances muscle mass and exercise capacity reduces the risk of sarcopenia and lowers postoperative complications e. g. pneumonia atelectasis ultimately shortening hospital stays and improving quality of life. At the mechanistic level exercise influences lung cancer progression through multiple pathways. First it modulates the tumor microenvironment TME by promoting immune cell infiltration e. g. CD8 + T cells and potentially converting "immune-desert" or " immune-excluded" TME into an " immune-inflamed" phenotype thereby enhancing anti-tumor immunity. Second exercise affects tumor angiogenesis ameliorates hypoxia and regulates key factors such as vascular endothelial growth factor . Furthermore exercise promotes cancer cell apoptosis by upregulating tumor suppressor p53 and activating the BAX/ BAK-Caspase - 3 apoptotic pathway thereby inhibiting tumor growth. However different exercise modalities e. g. endurance training vs. high-intensity interval training HIIT exhibit varying effects on the immune microenvironment and the underlying mechanisms require further investigation. Exercise therapy has important clinical application value in the management of lung cancer which can not only improve the physiological function and quality of life of patients but also synergistically enhance the anti - tumor effect through immune regulation and pro apoptotic effect. This article aims to summarize the clinical effect and mechanism of action of exercise therapy.