Impact of pre-chemotherapy locomotive syndrome status on short-term adverse outcome events in elderly lung cancer patients: A longitudinal study

doi:10.5312/wjo.v17.i3.115155

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Mar 18, 2026 (publication date) through Mar 16, 2026

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World Journal of Orthopedics

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World J Orthop. Mar 18, 2026; 17(3): 115155
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.115155

Impact of pre-chemotherapy locomotive syndrome status on short-term adverse outcome events in elderly lung cancer patients: A longitudinal study

Dan-Hua Liang, Xiao-Rui Feng, Lan Li, Ying Chen, Yu-Ling Yang

Dan-Hua Liang, Lan Li, Ying Chen, Yu-Ling Yang, Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China

Xiao-Rui Feng, Operating Room, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China

Co-first authors: Dan-Hua Liang and Xiao-Rui Feng.

Author contributions: Liang DH, Feng XR, and Yang YL designed the research study; Feng XR, Li L, and Chen Y performed the research; Li L and Yang YL contributed new reagents and analytic tools; Liang DH and Feng XR analyzed the data and wrote the manuscript. Liang DH and Feng XR contributed equally to this manuscript and are co-first authors. All authors have read and approved the final manuscript.

Supported by Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project, No. MS2024063; Research Project on Hospital Management Innovation in Jiangsu Province, No. JSYGY-3-2024-601; the Regional Medical Center Development Program Under the Partnership Between Jiangnan University Affiliated Hospital and Donghai County People’s Hospital, No. DHBFH202501 and No. DHBFH202503; and the Scientific and Technological Achievements Promotion Project of Wuxi Municipal Health Commission Project Program, No. LCYJ202336.

Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Affiliated Hospital of Jiangnan University, No. LS2023101.

Clinical trial registration statement: This study is registered at ChiCTR.org.cn, registration number: No. ChiCTR2400079958 (available from: https://www.chictr.org.cn/bin/home).

Informed consent statement: Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The datasets used during the current study are available from the corresponding author on reasonable request.

Corresponding author: Yu-Ling Yang, PhD, Department of Oncology, Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Wuxi 214122, Jiangsu Province, China. yulingzxc@163.com

Received: October 14, 2025
Revised: November 10, 2025
Accepted: January 5, 2026
Published online: March 18, 2026
Processing time: 158 Days and 7.9 Hours

Abstract

BACKGROUND

Despite growing recognition of locomotive syndrome (LS) in the general elderly population, research focusing on its prevalence and clinical implications among elderly lung cancer patients remains limited. Existing studies have predominantly examined nutritional, immune, or systemic functional factors influencing chemotherapy tolerance and prognosis, while musculoskeletal health - an equally critical determinant of patient outcomes - has received insufficient attention.

AIM

To investigate the effect of pre-chemotherapy LS status on short-term adverse outcome events among elderly lung cancer patients.

METHODS

This study employed convenience sampling to recruit 410 elderly lung cancer patients admitted to the Affiliated Hospital of Jiangnan University from January 2024 to June 2024. Clinical data of the patients were collected, and they were divided into the LS group and the non-LS group according to their LS status before chemotherapy. The patients were followed up for 6 months. Toxicity during chemotherapy and adverse outcomes such as death, incapacitation, and unplanned hospitalization during the follow-up period were recorded.

RESULTS

This study finished data collection on 386 elderly lung cancer patients. Among them, 161 were diagnosed with LS before chemotherapy, while 225 were non-LS patients. After chemotherapy, the incidence of LS was significantly higher in the LS group than in the non-LS group (P < 0.05). During the chemotherapy, the LS group experienced a significantly greater incidence of toxicities when compared to the non-LS group (P < 0.05). The toxicity grading in the LS group was significantly higher than that in the non-LS group (P < 0.05). During the follow-up period, the mortality rate of the LS group was significantly higher than that of the non-LS group (P < 0.05). Moreover, patients in the LS group faced more severe incapacitation and a higher rate of unplanned hospitalizations than those in the non-LS group (P < 0.05).

CONCLUSION

Pre-chemotherapy LS has become more prevalent among elderly lung cancer patients, and its incidence further increases after chemotherapy. Elderly lung cancer patients with pre-chemotherapy LS experience numerous and severe toxic side effects during chemotherapy. They also face a high risk of death, suffer from severe disability, and have a high rate of unplanned hospitalization during the follow-up period.

Keywords: Elderly lung cancer patients; Antitumor combination chemotherapy regimens; Locomotive syndrome; Drug-related adverse effects; Pre-chemotherapy

Core Tip: Currently, more studies focus on the effects of nutritional, immune, or systemic functional status on chemotherapy toxicity and prognosis in elderly lung cancer patients. In contrast, research on the locomotive syndrome status of elderly lung cancer patients before chemotherapy is relatively scarce. In this study, we intend to investigate the locomotive syndrome status of elderly lung cancer patients before chemotherapy and analyze its impact on short-term adverse events.