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

  • Author / Creator
    Morielli, Andria R
  • 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.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
    • Physical Education and Recreation
  • Supervisor / co-supervisor and their department(s)
    • Courneya, Kerry (Physical Education and Recreation)
  • Examining committee members and their departments
    • Normand, Boulé (Physical Education and Recreation)
    • Diane Severin (Department of Oncology)