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Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study

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dc.contributor.author Argudo Aguirre, Nuria
dc.contributor.author Rodó-Pin, Anna
dc.contributor.author Martinez-Llorens, Juana María
dc.contributor.author Marco Navarro, Ester
dc.contributor.author Visa Turmo, Laura
dc.contributor.author Messaggi-Sartor, Monique, 1984-
dc.contributor.author Balañá Corberó, Ana, 1981-
dc.contributor.author Ramón Moros, José Manuel
dc.contributor.author Rodríguez Chiaradia, Diego Agustín
dc.contributor.author Grande Posa, Luís
dc.contributor.author Pera Roman, Manuel Ramón
dc.date.accessioned 2021-06-17T06:53:38Z
dc.date.issued 2021
dc.identifier.citation Argudo N, Rodó-Pin A, Martínez-Llorens J, Marco E, Visa L, Messaggi-Sartor M, et al. Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study. Dis Esophagus. 2021 Apr 7; 34(4): doaa086. DOI: 10.1093/dote/doaa086
dc.identifier.issn 1120-8694
dc.identifier.uri http://hdl.handle.net/10230/47916
dc.description.abstract 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 < 0.05). Exercise led to a significant improvement of VO2peak (15.5 vs. 19.6 mL/kg/min, P < 0.05). Exercise training was associated with clinically relevant improvements in some domains of HRQL, with the social and role function increasing by 10.5 and 11.6 points, respectively, and appetite loss and fatigue declining by 16 and 10.5, respectively. We conclude that a structured exercise training intervention is feasible and safe following NAT in patients with esophagogastric cancer, and it has positive effects to restore exercise capacity to baseline levels within 5 weeks with some improvements in HRQL.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Oxford University Press
dc.rights © Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in Diseases of the esophagus following peer review. The version of record Argudo N, Rodó-Pin A, Martínez-Llorens J, Marco E, Visa L, Messaggi-Sartor M, et al. Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study. Dis Esophagus. 2021 Apr 7; 34(4): doaa086 is available online at: https://academic.oup.com/dote/article/34/4/doaa086/5906903, http://dx.doi.org/10.1093/dote/doaa086
dc.title Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1093/dote/doaa086
dc.subject.keyword Esophagogastric cancer
dc.subject.keyword Feasibility
dc.subject.keyword High-intensity interval training
dc.subject.keyword Neoadjuvant therapy
dc.subject.keyword Prehabilitation
dc.subject.keyword Tolerability
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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