• Eur J Surg Oncol · Sep 2016

    Feasibility and preliminary effectiveness of a physical exercise training program during neoadjuvant chemoradiotherapy in individual patients with rectal cancer prior to major elective surgery.

    • HeldensA F J MAFDepartment of Epidemiology, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Physical Therapy, Maastr, B C Bongers, J de Vos-Geelen, N L U van Meeteren, and A F Lenssen.
    • Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Physical Therapy, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: aniek.heldens@mumc.nl.
    • Eur J Surg Oncol. 2016 Sep 1; 42 (9): 1322-30.

    BackgroundDiverse fractions of patients with locally advanced resectable rectal cancer receive neoadjuvant chemoradiotherapy (NACRT). NACRT is known to decrease physical fitness, an undesirable side effect. This pilot aimed to determine the feasibility and preliminary effectiveness of a supervised outpatient physical exercise training program during NACRT in these patients.MethodsWe included 13 out of 20 eligible patients (11 males, mean ± SD age: 59.1 ± 19.7 years) with rectal cancer who participated in the exercise training program during NACRT. Feasibility was determined by adherence and number of adverse events. Physical fitness was compared at baseline (B), after five (T1) and ten weeks (T2) of training, and eight weeks postoperatively (T3) using repeated-measures analysis of variance.ResultsNine patients (69.2%) completed the program without adverse events. Four patients dropped out. The program was feasible and safe, with a total attendance rate of 95.7%. Leg muscle strength (mean ± SD: 104.0 ± 32.3 versus 144.8 ± 45.6 kg; P < 0.001) and arm muscle strength (mean ± SD: 48.7 ± 13.8 kg versus 36.1 ± 11.0 kg, P = 0.002) increased significantly between B and T2, respectively. A slight, non-significant, increase in functional exercise capacity was found.ConclusionThis pilot demonstrated that a supervised outpatient physical exercise training program for individual patients with locally advanced resectable rectal cancer during NACRT is feasible for a large part of the patients, safe and seems able to prevent an often seen decline in physical fitness during NACRT. A larger study into the cost-effectiveness of this approach is warranted.Copyright © 2016 Elsevier Ltd. All rights reserved.

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