TY - JOUR
T1 - Exercise prehabilitation during neoadjuvant chemotherapy may enhance tumour regression in oesophageal cancer
T2 - results from a prospective non-randomised trial
AU - Zylstra, Janine
AU - Whyte, Greg P
AU - Beckmann, Kerri
AU - Pate, James
AU - Santaolalla, Aida
AU - Gervais-Andre, Louise
AU - Russell, Beth
AU - Maisey, Nick
AU - Waters, Justin
AU - Tham, Gemma
AU - Lagergren, Jesper
AU - Green, Michael
AU - Kelly, Mark
AU - Baker, Cara
AU - Van Hemelrijck, Mieke
AU - Goh, Vicky
AU - Gossage, James
AU - Browning, Mike
AU - Davies, Andrew
N1 - Funding Information:
The work was supported by the Guy’s and St Thomas’ Charity, London (EFT 150709 to AD); Centre for Health and Human Performance, London.
Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - BACKGROUND: There is increasing evidence for the use of exercise in cancer patients and data supporting enhanced tumour volume reduction following chemotherapy in animal models. To date, there is no reported histopathological evidence of a similar oncological benefit in oesophageal cancer.METHODS: A prospective non-randomised trial compared a structured prehabilitation exercise intervention during neoadjuvant chemotherapy and surgery versus conventional best-practice for oesophageal cancer patients. Biochemical and body composition analyses were performed at multiple time points. Outcome measures included radiological and pathological markers of disease regression. Logistic regression calculated ORs with 95% CI for the likelihood of pathological response adjusting for chemotherapy regimen and chemotherapy delivery.RESULTS: Comparison of the Intervention (n=21) and Control (n=19) groups indicated the Intervention group had higher rates of tumour regression (Mandard TRG 1-3 Intervention n=15/20 (75%) vs Control n=7/19 (36.8%) p=0.025) including adjusted analyses (OR 6.57; 95% CI 1.52 to 28.30). Combined tumour and node downstaging (Intervention n=9 (42.9%) vs Control n=3 (15.8%) p=0.089) and Fat Free Mass index were also improved (Intervention 17.8 vs 18.7 kg/m2; Control 16.3 vs 14.7 kg/m2, p=0.026). Differences in markers of immunity (CD-3 and CD-8) and inflammation (IL-6, VEGF, INF-y, TNFa, MCP-1 and EGF) were observed.CONCLUSION: The results suggest improved tumour regression and downstaging in the exercise intervention group and should prompt larger studies on this topic.TRIAL REGISTRATION NUMBER: NCT03626610.
AB - BACKGROUND: There is increasing evidence for the use of exercise in cancer patients and data supporting enhanced tumour volume reduction following chemotherapy in animal models. To date, there is no reported histopathological evidence of a similar oncological benefit in oesophageal cancer.METHODS: A prospective non-randomised trial compared a structured prehabilitation exercise intervention during neoadjuvant chemotherapy and surgery versus conventional best-practice for oesophageal cancer patients. Biochemical and body composition analyses were performed at multiple time points. Outcome measures included radiological and pathological markers of disease regression. Logistic regression calculated ORs with 95% CI for the likelihood of pathological response adjusting for chemotherapy regimen and chemotherapy delivery.RESULTS: Comparison of the Intervention (n=21) and Control (n=19) groups indicated the Intervention group had higher rates of tumour regression (Mandard TRG 1-3 Intervention n=15/20 (75%) vs Control n=7/19 (36.8%) p=0.025) including adjusted analyses (OR 6.57; 95% CI 1.52 to 28.30). Combined tumour and node downstaging (Intervention n=9 (42.9%) vs Control n=3 (15.8%) p=0.089) and Fat Free Mass index were also improved (Intervention 17.8 vs 18.7 kg/m2; Control 16.3 vs 14.7 kg/m2, p=0.026). Differences in markers of immunity (CD-3 and CD-8) and inflammation (IL-6, VEGF, INF-y, TNFa, MCP-1 and EGF) were observed.CONCLUSION: The results suggest improved tumour regression and downstaging in the exercise intervention group and should prompt larger studies on this topic.TRIAL REGISTRATION NUMBER: NCT03626610.
UR - http://www.scopus.com/inward/record.url?scp=85127729013&partnerID=8YFLogxK
U2 - 10.1136/bjsports-2021-104243
DO - 10.1136/bjsports-2021-104243
M3 - Article
C2 - 35105604
SN - 1473-0480
VL - 56
SP - 402
EP - 409
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 7
M1 - bjsports-2021-104243
ER -
