Feasibility, Safety, and Preliminary Efficacy of Exercise During and After Neoadjuvant Rectal Cancer Treatment: A Phase II Randomized Controlled Trial.


Journal

Clinical colorectal cancer
ISSN: 1938-0674
Titre abrégé: Clin Colorectal Cancer
Pays: United States
ID NLM: 101120693

Informations de publication

Date de publication:
09 2021
Historique:
received: 31 12 2020
revised: 06 05 2021
accepted: 13 05 2021
pubmed: 24 6 2021
medline: 14 1 2022
entrez: 23 6 2021
Statut: ppublish

Résumé

Neoadjuvant chemoradiation (NACRT) improves outcomes for patients with rectal cancer; however, there are dose-limiting toxicities and only a 15% to 27% pathologic complete response (pCR) rate. Exercise may help manage toxicities and improve treatment response, but feasibility and early efficacy have not been established. EXERT was a phase II trial designed to establish the feasibility and safety of exercise and provide the first evidence of efficacy. Patients with rectal cancer scheduled to receive NACRT were randomly assigned to usual care (n = 18) or exercise (n = 18) involving supervised exercise during NACRT and unsupervised exercise after NACRT. The primary outcome was cardiorespiratory fitness (VO Median attendance at supervised exercise sessions during NACRT was 82%, and median self-reported exercise after NACRT was 90 min/wk. From baseline to post-NACRT, VO Exercise during and after NACRT is feasible for many patients with rectal cancer and may improve pCR despite limited fitness improvements. Larger trials are warranted to confirm if exercise is an effective intervention for improving treatment outcomes in this clinical setting.

Sections du résumé

BACKGROUND
Neoadjuvant chemoradiation (NACRT) improves outcomes for patients with rectal cancer; however, there are dose-limiting toxicities and only a 15% to 27% pathologic complete response (pCR) rate. Exercise may help manage toxicities and improve treatment response, but feasibility and early efficacy have not been established. EXERT was a phase II trial designed to establish the feasibility and safety of exercise and provide the first evidence of efficacy.
MATERIALS AND METHODS
Patients with rectal cancer scheduled to receive NACRT were randomly assigned to usual care (n = 18) or exercise (n = 18) involving supervised exercise during NACRT and unsupervised exercise after NACRT. The primary outcome was cardiorespiratory fitness (VO
RESULTS
Median attendance at supervised exercise sessions during NACRT was 82%, and median self-reported exercise after NACRT was 90 min/wk. From baseline to post-NACRT, VO
CONCLUSION
Exercise during and after NACRT is feasible for many patients with rectal cancer and may improve pCR despite limited fitness improvements. Larger trials are warranted to confirm if exercise is an effective intervention for improving treatment outcomes in this clinical setting.

Identifiants

pubmed: 34158253
pii: S1533-0028(21)00046-3
doi: 10.1016/j.clcc.2021.05.004
pii:
doi:

Types de publication

Clinical Trial, Phase II Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

216-226

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Andria R Morielli (AR)

Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.

Nawaid Usmani (N)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Normand G Boulé (NG)

Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.

Diane Severin (D)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Keith Tankel (K)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Kurian Joseph (K)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Tirath Nijjar (T)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Alysa Fairchild (A)

Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.

Kerry S Courneya (KS)

Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada. Electronic address: kerry.courneya@ualberta.ca.

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