---
title: "APART-LUNG: Step Counts and Physical Activity During Radiotherapy for Lung Cancer"
id: "pubmed-42674679"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674679"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674679/"
doi: "10.21873/anticanres.18359"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# APART-LUNG: Step Counts and Physical Activity During Radiotherapy for Lung Cancer
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674679
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674679/)
- **DOI:** [10.21873/anticanres.18359](https://doi.org/10.21873%2Fanticanres.18359)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The APART-LUNG pilot study evaluated changes in **physical activity** during a course of radiotherapy for lung cancer by measuring smartphone-recorded **step counts** (weekly mean steps per smartphone wear-hour) in the first and fifth weeks of treatment. - Twenty patients were enrolled; 19 patients were eligible for analysis. The study's primary endpoint was the within-patient difference in step counts between week 5 and week 1. - Mean steps per wear-hour were 344.3 ± 171.6 in week 1 and 363.5 ± 189.9 in week 5. Median values were 318.4 (range 123.3–762.9) at week 1 and 300.3 (range 108.3–704.7) at week 5. - The difference between week 5 and week 1 was not statistically significant (p = 0.465); overall, step counts did not significantly decrease during radiotherapy in this cohort. - Individual trajectories varied: step counts decreased in nine patients, increased in nine patients, and remained almost unchanged in one patient (increase of 3 steps). - Exploratory analyses assessed associations between change in step counts and age, sex, performance status, comorbidity, body-mass index, histology, and **concurrent systemic treatment**; no characteristic reached statistical significance. - The largest observed difference in the proportion of patients with decreased steps related to concurrent systemic treatment (no vs. yes), with a 37% difference, suggesting a potential signal for future study. - The authors conclude that step counts remained broadly stable during radiotherapy and that concurrent systemic treatment should be considered when designing future prospective trials of activity during treatment. - Keywords reported: Lung cancer; concurrent systemic treatment; physical activity; radiotherapy; step counts.
## Clinical Analysis & Structured Key Points
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dirk.rades@uksh.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Maria K Streubel](https://pubmed.ncbi.nlm.nih.gov/?term=Streubel+MK&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Laura Doehring](https://pubmed.ncbi.nlm.nih.gov/?term=Doehring+L&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Darejan Lomidze](https://pubmed.ncbi.nlm.nih.gov/?term=Lomidze+D&cauthor_id=42674679)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-4 "Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi, Georgia."), [Jasna But-Hadžić](https://pubmed.ncbi.nlm.nih.gov/?term=But-Had%C5%BEi%C4%87+J&cauthor_id=42674679)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-5 "Department of Radiotherapy, Institute of Oncology Ljubljana and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia."), [Jon Cacicedo](https://pubmed.ncbi.nlm.nih.gov/?term=Cacicedo+J&cauthor_id=42674679)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-6 "Department of Radiation Oncology, Cruces University Hospital and Biobizkaia Health Research Institute, Barakaldo, Spain."), [Stefan Janssen](https://pubmed.ncbi.nlm.nih.gov/?term=Janssen+S&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-7 "MVZ RON Niedersachsen Strahlentherapie GmbH, Hannover, Germany."), [Hanne Falk Grauslund](https://pubmed.ncbi.nlm.nih.gov/?term=Grauslund+HF&cauthor_id=42674679)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-8 "Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark."), [Charlotte Kristiansen](https://pubmed.ncbi.nlm.nih.gov/?term=Kristiansen+C&cauthor_id=42674679)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-8 "Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark."), [Sabine Bohnet](https://pubmed.ncbi.nlm.nih.gov/?term=Bohnet+S&cauthor_id=42674679)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-9 "Department of Pulmonology, University of Luebeck, Luebeck, Germany.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-10 "Department of Pulmonology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Cristian F Schulz](https://pubmed.ncbi.nlm.nih.gov/?term=Schulz+CF&cauthor_id=42674679)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-11 "Department of Radiation Oncology, Christian-Albrechts-University Kiel, Kiel, Germany.")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#full-view-affiliation-12 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel Campus, Kiel, Germany.") Affiliations Expand ### Affiliations * 1 Department of Radiation Oncology, University of Luebeck, Luebeck, Germany; dirk.rades@uksh.de. * 2 Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany. * 3 Department of Radiation Oncology, University of Luebeck, Luebeck, Germany. * 4 Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi, Georgia. * 5 Department of Radiotherapy, Institute of Oncology Ljubljana and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia. * 6 Department of Radiation Oncology, Cruces University Hospital and Biobizkaia Health Research Institute, Barakaldo, Spain. * 7 MVZ RON Niedersachsen Strahlentherapie GmbH, Hannover, Germany. * 8 Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark. * 9 Department of Pulmonology, University of Luebeck, Luebeck, Germany. * 10 Department of Pulmonology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany. * 11 Department of Radiation Oncology, Christian-Albrechts-University Kiel, Kiel, Germany. * 12 Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel Campus, Kiel, Germany. * PMID: **42674679** * DOI: [ 10.21873/anticanres.18359 ](https://doi.org/10.21873/anticanres.18359) Item in Clipboard # Physical Activity During a Course of Radiotherapy for Lung Cancer - Results of the APART-LUNG Study Dirk Rades et al. Anticancer Res. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Anticancer Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anticancer+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Anticancer+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674679/) . 2026 Sep;46(9):5129-5140. doi: 10.21873/anticanres.18359. ### Authors [Dirk Rades](https://pubmed.ncbi.nlm.nih.gov/?term=Rades+D&cauthor_id=42674679)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-1 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany; dirk.rades@uksh.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Maria K Streubel](https://pubmed.ncbi.nlm.nih.gov/?term=Streubel+MK&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Laura Doehring](https://pubmed.ncbi.nlm.nih.gov/?term=Doehring+L&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-2 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Darejan Lomidze](https://pubmed.ncbi.nlm.nih.gov/?term=Lomidze+D&cauthor_id=42674679)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-4 "Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi, Georgia."), [Jasna But-Hadžić](https://pubmed.ncbi.nlm.nih.gov/?term=But-Had%C5%BEi%C4%87+J&cauthor_id=42674679)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-5 "Department of Radiotherapy, Institute of Oncology Ljubljana and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia."), [Jon Cacicedo](https://pubmed.ncbi.nlm.nih.gov/?term=Cacicedo+J&cauthor_id=42674679)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-6 "Department of Radiation Oncology, Cruces University Hospital and Biobizkaia Health Research Institute, Barakaldo, Spain."), [Stefan Janssen](https://pubmed.ncbi.nlm.nih.gov/?term=Janssen+S&cauthor_id=42674679)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-3 "Department of Radiation Oncology, University of Luebeck, Luebeck, Germany.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-7 "MVZ RON Niedersachsen Strahlentherapie GmbH, Hannover, Germany."), [Hanne Falk Grauslund](https://pubmed.ncbi.nlm.nih.gov/?term=Grauslund+HF&cauthor_id=42674679)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-8 "Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark."), [Charlotte Kristiansen](https://pubmed.ncbi.nlm.nih.gov/?term=Kristiansen+C&cauthor_id=42674679)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-8 "Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark."), [Sabine Bohnet](https://pubmed.ncbi.nlm.nih.gov/?term=Bohnet+S&cauthor_id=42674679)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-9 "Department of Pulmonology, University of Luebeck, Luebeck, Germany.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-10 "Department of Pulmonology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany."), [Cristian F Schulz](https://pubmed.ncbi.nlm.nih.gov/?term=Schulz+CF&cauthor_id=42674679)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-11 "Department of Radiation Oncology, Christian-Albrechts-University Kiel, Kiel, Germany.")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42674679/#short-view-affiliation-12 "Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel Campus, Kiel, Germany.") ### Affiliations * 1 Department of Radiation Oncology, University of Luebeck, Luebeck, Germany; dirk.rades@uksh.de. * 2 Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany. * 3 Department of Radiation Oncology, University of Luebeck, Luebeck, Germany. * 4 Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi, Georgia. * 5 Department of Radiotherapy, Institute of Oncology Ljubljana and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia. * 6 Department of Radiation Oncology, Cruces University Hospital and Biobizkaia Health Research Institute, Barakaldo, Spain. * 7 MVZ RON Niedersachsen Strahlentherapie GmbH, Hannover, Germany. * 8 Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark. * 9 Department of Pulmonology, University of Luebeck, Luebeck, Germany. * 10 Department of Pulmonology, University Medical Center Schleswig-Holstein, Luebeck Campus, Luebeck, Germany. * 11 Department of Radiation Oncology, Christian-Albrechts-University Kiel, Kiel, Germany. * 12 Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel Campus, Kiel, Germany. * PMID: **42674679** * DOI: [ 10.21873/anticanres.18359 ](https://doi.org/10.21873/anticanres.18359) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Patients receiving radiotherapy for lung cancer may experience treatment-related adverse effects that reduce physical activity. Smartphone-based reminder applications may help patients maintain daily activity; however, information on changes in step counts during radiotherapy is limited. The APART-LUNG study investigated changes in physical activity between the first and fifth weeks of radiotherapy and explored potential factors associated with decreased activity. **Patients and methods:** Twenty patients were enrolled, of whom 19 were eligible for analysis. Physical activity was assessed as the weekly mean number of steps per smartphone wear-hour during weeks 1 and 5 of radiotherapy. The primary endpoint was the within-patient difference between week 5 and week 1. Associations between changes in step counts and age, sex, performance status, comorbidity, body-mass index, histology, and concurrent systemic treatment were explored. **Results:** The mean numbers of steps per wear-hour were 344.3±171.6 in week 1 and 363.5±189.9 in week 5. Median values were 318.4 (range=123.3-762.9) and 300.3 (range=108.3-704.7) steps, respectively (_p_ =0.465). The weekly average number of steps per wear-hour decreased in nine patients, increased in nine patients, and remained almost constant (plus three steps) in one patient. No characteristic was significantly associated with a decrease in steps. The greatest difference regarding the proportion of patients with a decrease in steps was observed for concurrent systemic treatment (no _vs_. yes, difference=37%). **Conclusion:** In this pilot study, step counts did not significantly decrease during radiotherapy for lung cancer. No investigated characteristic was significantly associated with decreased physical activity, although concurrent systemic treatment showed the strongest signal and should be considered in the design of future prospective trials. **Keywords:** Lung cancer; concurrent systemic treatment; physical activity; radiotherapy; step counts. 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