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Permanent link (DOI): https://doi.org/10.7939/R3BN9XB2J

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Feasibility of an Aerobic Exercise Intervention in Rectal Cancer Patients During and After Neoadjuvant Chemoradiotherapy Open Access

Descriptions

Other title
Subject/Keyword
Exercise
Physical functioning
Cancer survivor
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Morielli, Andria R
Supervisor and department
Courneya, Kerry (Physical Education and Recreation)
Examining committee member and department
Normand, Boulé (Physical Education and Recreation)
Diane Severin (Department of Oncology)
Department
Physical Education and Recreation
Specialization

Date accepted
2015-09-24T15:45:52Z
Graduation date
2015-11
Degree
Master of Science
Degree level
Master's
Abstract
Background: Standard treatment for locally advanced rectal cancer includes long-course neoadjuvant chemoradiotherapy (NACRT) followed by definitive surgery. NACRT improves outcomes but it is also associated with significant toxicities and declines in physical fitness that may impede treatment response, symptom management, and post-surgical recovery. Exercise may improve these outcomes but the feasibility of exercise during NACRT has not been established. Purpose: The primary objective of this phase I study was to assess the safety and feasibility of an aerobic exercise intervention in rectal cancer patients during and immediately after NACRT. Changes in objective health-related fitness and patient-reported outcomes were also tracked. Methods: Rectal cancer patients scheduled to receive long-course NACRT followed by definitive surgery were recruited from the Cross Cancer Institute in Edmonton Alberta. All participants received a supervised moderate-intensity aerobic exercise program 3 days/week during NACRT followed by unsupervised aerobic exercise for ≥ 150 minutes/week after NACRT. Feasibility was determined by eligibility rate, recruitment rate, follow-up rate, exercise adherence and adverse events. Health-related fitness outcomes and patient-reported outcomes were assessed pre-NACRT, post-NACRT and pre-surgery. Results: Of 45 rectal cancer patients screened, 32 (71%) were eligible and 18 (56%) of those were recruited. Follow-up post-NACRT was 83% for health-related fitness outcomes and 94% for patient-reported outcomes. Attendance for the supervised exercise sessions was 74%. The mean total aerobic exercise minutes/week was 222 ± 155 minutes for the unsupervised exercise. There were no adverse events resulting from the exercise intervention. Most health-related fitness outcomes and patient-reported outcomes declined during NACRT and recovered from post-NACRT to pre-surgery. For example, estimated VO2 max declined from pre- to post-NACRT (mean change, -1.3 ml/kg/min; 95% CI, -3.6 to 1.7) and then increased from post-NACRT to pre-surgery (mean change +2.4 ml/kg/min; 95% CI, -0.9 to 5.7). Conclusion: Aerobic exercise is safe and feasible for rectal cancer patients during and after NACRT. Phase II randomized trials to establish the harms and benefits of aerobic exercise in this patient population are warranted.
Language
English
DOI
doi:10.7939/R3BN9XB2J
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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