# Radiotherapy-Related Clinical and Functional Sequelae in Lung Cancer Survivors
## 4 Discussion  
This study aimed to analyze the functional and clinical profile of lung cancer survivors after receiving radiotherapy treatment and to evaluate the quality of life of these patients. The results showed higher functional impairment and worse symptoms and perceived health-related quality of life after completing radiotherapy treatment. The study sample accurately reflected the broader population of lung cancer patients receiving radiotherapy treatment. We observed similar sociodemographic characteristics [33], a homogeneous etiological profile [34], and a radiotherapeutic approach similar to that received by lung cancer survivors in previous studies [35]. Our results showed an increase in symptoms after completing radiotherapy treatment, with a significant increase in cough, dyspnea, and perceived fatigue compared to pre-radiation symptom levels. Previous studies in other cancer populations have shown similar results to ours. For example, the study by [PERSON] et al. [36] also showed a high prevalence of radiotherapy-related symptoms in prostate cancer survivors. The presence of a significantly high level of dyspnea is an important symptom to consider due to its importance as a predictor of long-term survival after anti-cancer treatment [37]. Fatigue is also a cardinal symptom of these patients. In this regard, published studies have shown that perceived fatigue is maintained even 5 years after completing anti-cancer treatment [38]. Our findings on physical activity levels are also in line with the decline presented in the physical activity and exercise capacity of other cancer survivors who have completed radiotherapy treatment [39]. Previous studies in lung cancer populations have reported that more than 70% of these patients do not generally achieve the physical activity recommendations for cancer survivors [40], which has a direct negative effect on their quality of life. Based on the articles published to date, it is important to note that this decline in physical activity levels could be influenced by a voluntary limitation of physical activity by \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **Before Radiotherapy** & **After Radiotherapy** & \multirow{2}{*}{_p-Value_} \\  & _(\(\mu\) = 65)_ & _(\(\mu\) = 61)_ & \\ \hline Mobility subscore & 1.62 \(\pm\) 0.93 & 2.08 \(\pm\) 0.90 & 0.007 \({}^{*}\) \\ Self-care subscore & 1.31 \(\pm\) 0.53 & 1.69 \(\pm\) 0.94 & 0.007 \({}^{*}\) \\ Activities of daily life subscore & 1.82 \(\pm\) 1.13 & 1.95 \(\pm\) 0.83 & 0.466 \\ Pain subscore & 1.61 \(\pm\) 1.05 & 2.3 \(\pm\) 0.82 & 0.000 \({}^{**}\) \\ Anxiety-depression subscore & 1.67 \(\pm\) 0.87 & 1.82 \(\pm\) 0.92 & 0.365 \\ VAS subscore (0–100) & 67.38 \(\pm\) 19.14 & 60.90 \(\pm\) 19.89 & 0.069 \\ \hline \hline \end{tabular} Data expressed as mean \(\pm\) SD; \({}^{*}p\) < 0.005; \({}^{**}p\) < 0.001. Abbreviations: VAS, visual analog scale.  
\end{table} 
Table 3: Quality of life of lung cancer patients included in study before and after radiotherapy treatment. patients to avoid triggering the symptoms they experience [14]. These symptoms cause great discomfort to patients and interfere with their activities of daily living [7]. This clinical condition is in line with the results obtained on barriers to physical activity, which increase significantly after completing radiotherapy treatment. Moreover, previous studies have obtained similar results to ours in populations with different types of cancer [41]. Patients in this study also showed a significant decline in their self-perceived quality of life after radiotherapy. This decline has been reported in previous studies that assessed the evolution of lung cancer survivors in advanced stages. For example, the study by [PERSON] et al. [42] found disturbances in 37.6% of the sample's activities of daily living, 26.6% of their mobility, and 5.2% of their self-care. However, the heterogeneity of the population did not allow them to establish a relationship between this decline and factors such as the treatment received.