Feasibility of early multimodal interventions for elderly patients with advanced pancreatic and non‐small‐cell lung cancer

Autor: Teiko Yamaguchi, Taro Okayama, Ayumu Morikawa, Koichi Takayama, Tetsuya Tsuji, Satoru Miura, Takashi Higashiguchi, Tateaki Naito, Katsuhiro Omae, Shuichi Mitsunaga, Akio Inui, Naoharu Mori, Florian Strasser, Toshimi Inano, Noriatsu Tatematsu, Keita Mori, Toshiaki Takahashi, Takako Mouri
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Lung Neoplasms
Psychological intervention
Phases of clinical research
lcsh:QM1-695
03 medical and health sciences
0302 clinical medicine
Elderly
Physiology (medical)
Pancreatic cancer
Internal medicine
Carcinoma
Non-Small-Cell Lung
medicine
Clinical endpoint
Humans
Orthopedics and Sports Medicine
Adverse effect
Lung cancer
Muscle
Skeletal
Aged
Aged
80 and over
business.industry
Physical activity
Cancer
Non‐small‐cell lung cancer
Cancer cachexia
lcsh:Human anatomy
Original Articles
medicine.disease
Confidence interval
Exercise Therapy
Pancreatic Neoplasms
030104 developmental biology
Nutrition Assessment
Physical Fitness
030220 oncology & carcinogenesis
Multimodal intervention
Feasibility Studies
Original Article
Female
Nutrition Therapy
lcsh:RC925-935
business
Zdroj: Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle, Vol 10, Iss 1, Pp 73-83 (2019)
ISSN: 2190-6009
2190-5991
Popis: Background Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme. Methods This was a multicentre prospective single‐arm study. We recruited 30 of 46 screened patients aged ≥70 years scheduled to receive first‐line chemotherapy for newly diagnosed, advanced pancreatic, or non‐small‐cell lung cancer. Physical activity was measured using pedometers/accelerometer (Lifecorder®, Suzuken Co., Ltd., Japan). An 8 week educational intervention comprised three exercise and three nutritional sessions. The exercise interventions combined home‐based low‐intensity resistance training and counselling to promote physical activity. Nutritional interventions included standard nutritional counselling and instruction on how to manage symptoms that interfere with patient's appetite and oral intake. Supplements rich in branched‐chain amino acids (Inner Power®, Otsuka Pharmaceutical Co., Ltd., Japan) were provided. The primary endpoint of the study was feasibility, which was defined as the proportion of patients attending ≥4 of six sessions. Secondary endpoints included compliance and safety. Results The median patient age was 75 years (range, 70–84). Twelve patients (40%) were cachectic at baseline. Twenty‐nine patients attended ≥4 of the six planned sessions (96.7%, 95% confidence interval, 83.3 to 99.4). One patient dropped out due to deteriorating health status. The median proportion of days of compliance with supplement consumption and exercise performance were 99% and 91%, respectively. Adverse events possibly related to the NEXTAC programme were observed in five patients and included muscle pain (Grade 1 in two patients), arthralgia (Grade 1 in one patient), dyspnoea on exertion (Grade 1 in one patient), and plantar aponeurositis (Grade 1 in one patient). Conclusions The early induction of multimodal interventions showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non‐small‐cell lung cancer receiving concurrent chemotherapy. We are now conducting a randomized phase II study to measure the impact of these interventions on functional prognosis.
Databáze: OpenAIRE
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