Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study
| Autor: | Anna Balañá-Corberó, Manuel Pera, Anna Rodó-Pin, José M. Ramón, Diego A Rodríguez-Chiaradía, Laura Visa, Ester Marco, Núria Argudo, Luis Grande, Monique Messaggi-Sartor, Juana Martínez-Llorens |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms medicine.medical_treatment Prehabilitation Esophagogastric cancer Pilot Projects Interval training 03 medical and health sciences 0302 clinical medicine Stomach Neoplasms medicine Humans 030212 general & internal medicine Exercise Neoadjuvant therapy business.industry Gastroenterology Infant Newborn VO2 max Preoperative Exercise Feasibility Cardiorespiratory fitness General Medicine Tolerability Neoadjuvant Therapy Surgery Exercise Therapy 030220 oncology & carcinogenesis High-intensity interval training Quality of Life Feasibility Studies business Chemoradiotherapy |
| Zdroj: | Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 34(4) |
| ISSN: | 1442-2050 |
| Popis: | Patients requiring surgery for locally advanced esophagogastric cancer often require neoadjuvant therapy (NAT), which may have a detrimental impact on cardiorespiratory reserve. The aims of this study were to investigate the feasibility and tolerability of a 5-week preoperative high-intensity interval training program after NAT, and to assess the potential effects of the training protocol on exercise capacity, muscle function, and health-related quality of life (HRQL). We prospectively studied consecutive patients with resectable locally advanced esophageal and gastric cancer in whom NAT was planned (chemo- or chemoradiotherapy). Feasibility was assessed with the TELOS (Technological, Economics, Legal, Operational, and Scheduling) components, and data on exercise tolerability (attendance and occurrence of adverse or unexpected events). Exercise capacity was assessed with peak oxygen uptake (VO2peak) in a cardiopulmonary exercise test at baseline, post-NAT, and following completion of a high-intensity interval exercise training (25 sessions). Changes in muscle strength and HRQL were also assessed. Of 33 recruited subjects (mean age 65 years), 17 received chemoradiotherapy and 16 chemotherapy. All the TELOS components were addressed before starting the intervention; from a total of 17 questions considered as relevant for a successful implementation, seven required specific actions to prevent potential concerns. Patients attended a mean of 19.4 (6.4) exercise sessions. The predefined level of attendance (≥15 sessions of scheduled sessions) was achieved in 27 out of 33 (81.8%) patients. Workload progression was adequate in 24 patients (72.7%). No major adverse events occurred. VO2peak decreased significantly between baseline and post-NAT (19.3 vs. 15.5 mL/Kg/min, P |
| Databáze: | OpenAIRE |
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