Literature DB >> 30657249

Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration: results from the REx trial.

S J Moug1, N Mutrie2, S J E Barry3, G Mackay4, R J C Steele5, C Boachie6, C Buchan7, A S Anderson8.   

Abstract

AIM: Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) experience physical deterioration and reductions in their quality of life. This feasibility study assessed prehabilitation (a walking intervention) before, during and after NACRT to inform a definitive multi-centred randomized clinical trial (REx trial).
METHODS: Patients planned for NACRT followed by potentially curative surgery were approached (August 2014-March 2016) (www.isrctn.com; 62859294). Prior to NACRT, baseline physical and psycho-social data were recorded using validated tools. Participants were randomized to either the intervention group (exercise counselling session followed by a 13-17 week telephone-guided walking programme) or a control group (standard care). Follow-up testing was undertaken 1-2 weeks before surgery.
RESULTS: Of the 296 screened patients, 78 (26%) were eligible and 48 (61%) were recruited. N = 31 (65%) were men with a mean age of 65.9 years (range 33.7-82.6). Mean intervention duration was 14 weeks with 75% adherence. n = 40 (83%) completed follow-up testing. Both groups recorded reductions in daily walking but the reduction was less in the intervention group although not statistically significant. Participants reported high satisfaction and fidelity to trial procedures.
CONCLUSION: This study demonstrates that prehabilitation is feasible in rectal cancer patients undergoing NACRT. Good recruitment, adherence, retention and patient satisfaction rates support the development of a fully powered trial. The effects of the intervention on physical outcomes were promising. Colorectal Disease
© 2019 The Association of Coloproctology of Great Britain and Ireland.

Entities:  

Keywords:  feasibility study; neoadjuvant therapy; prehabilitation; rectal cancer; surgery

Mesh:

Year:  2019        PMID: 30657249     DOI: 10.1111/codi.14560

Source DB:  PubMed          Journal:  Colorectal Dis        ISSN: 1462-8910            Impact factor:   3.788


  16 in total

Review 1.  Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery.

Authors:  Charlotte Jl Molenaar; Stefan J van Rooijen; Hugo Jp Fokkenrood; Rudi Mh Roumen; Loes Janssen; Gerrit D Slooter
Journal:  Cochrane Database Syst Rev       Date:  2022-05-19

2.  Feasibility of Rehabilitation during Chemoradiotherapy among Patients with Stage III Non-Small Cell Lung Cancer: A Proof-of-Concept Study.

Authors:  Melissa J J Voorn; Bart C Bongers; Vivian E M van Kampen-van den Boogaart; Elisabeth J M Driessen; Maryska L G Janssen-Heijnen
Journal:  Cancers (Basel)       Date:  2022-05-12       Impact factor: 6.575

Review 3.  Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: a narrative review.

Authors:  Elise Piraux; Gilles Caty; Frank Aboubakar Nana; Gregory Reychler
Journal:  SAGE Open Med       Date:  2020-06-17

4.  Feasibility and acceptability of a preoperative exercise program for patients undergoing major cancer surgery: results from a pilot randomized controlled trial.

Authors:  Daniel Steffens; Jane Young; Paula R Beckenkamp; James Ratcliffe; Freya Rubie; Nabila Ansari; Neil Pillinger; Cherry Koh; Phillip A Munoz; Michael Solomon
Journal:  Pilot Feasibility Stud       Date:  2021-01-13

5.  Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation.

Authors:  Iona Pearson; Sue Blackwell; Rebecca Fish; Sarah Daniels; Malcolm West; Nanette Mutrie; P Kelly; Stephen Knight; Nicola S Fearnhead; Susan Moug
Journal:  BMJ Open       Date:  2021-03-24       Impact factor: 2.692

6.  An exercise trial for adults undergoing neoadjuvant chemoradiotherapy for rectal cancer proves not feasible: recommendations for future trials.

Authors:  Jennifer Brunet; Jenson Price; Céline Delluc
Journal:  Trials       Date:  2021-01-06       Impact factor: 2.279

7.  Efficacy of Prehabilitation Including Exercise on Postoperative Outcomes Following Abdominal Cancer Surgery: A Systematic Review and Meta-Analysis.

Authors:  Jamie L Waterland; Orla McCourt; Lara Edbrooke; Catherine L Granger; Hilmy Ismail; Bernhard Riedel; Linda Denehy
Journal:  Front Surg       Date:  2021-03-19

8.  Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients.

Authors:  Laura J Halliday; Emre Doganay; Venetia Wynter-Blyth; Hayley Osborn; John Buckley; Krishna Moorthy
Journal:  J Gastrointest Surg       Date:  2020-04-20       Impact factor: 3.452

9.  Does prehabilitation modify muscle mass in patients with rectal cancer undergoing neoadjuvant therapy? A subanalysis from the REx randomised controlled trial.

Authors:  S J Moug; S J E Barry; S Maguire; N Johns; D Dolan; R J C Steele; C Buchan; G Mackay; A S Anderson; N Mutrie
Journal:  Tech Coloproctol       Date:  2020-06-20       Impact factor: 3.781

10.  The effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients: a randomised controlled trial (The EMPOWER Trial).

Authors:  Lisa Loughney; Malcolm A West; Michael P W Grocott; Sandy Jack; Helen Moyses; Andrew Bates; Graham J Kemp; Lesley Hawkins; Judit Varkonyi-Sepp; Shaunna Burke; Christopher P Barben; Peter M Calverley; Trevor Cox; Daniel H Palmer; Michael G Mythen
Journal:  Perioper Med (Lond)       Date:  2021-06-22
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