Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration: results from The REx trial

S. J. Moug, N. Mutrie, S. J. E. Barry, G. Mackay, R. J. C. Steele, C. Boachie, C. Buchan, A. S. Anderson

Research output: Contribution to journalArticle

Abstract

Aim: Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) experience physical deterioration and reductions in their quality of life. This feasibility study assessed prehabilitation (a walking intervention) before, during and after NACRT to inform a definitive multi-centred randomized clinical trial (REx trial). Methods: Patients planned for NACRT followed by potentially curative surgery were approached (August 2014–March 2016) (www.isrctn.com; 62859294). Prior to NACRT, baseline physical and psycho-social data were recorded using validated tools. Participants were randomized to either the intervention group (exercise counselling session followed by a 13–17 week telephone-guided walking programme) or a control group (standard care). Follow-up testing was undertaken 1–2 weeks before surgery. Results: Of the 296 screened patients, 78 (26%) were eligible and 48 (61%) were recruited. N = 31 (65%) were men with a mean age of 65.9 years (range 33.7–82.6). Mean intervention duration was 14 weeks with 75% adherence. n = 40 (83%) completed follow-up testing. Both groups recorded reductions in daily walking but the reduction was less in the intervention group although not statistically significant. Participants reported high satisfaction and fidelity to trial procedures. Conclusion: This study demonstrates that prehabilitation is feasible in rectal cancer patients undergoing NACRT. Good recruitment, adherence, retention and patient satisfaction rates support the development of a fully powered trial. The effects of the intervention on physical outcomes were promising.

LanguageEnglish
Pages548-562
Number of pages15
JournalColorectal Disease
Volume21
Issue number5
Early online date18 Jan 2019
DOIs
Publication statusPublished - 31 May 2019

Fingerprint

Chemoradiotherapy
Rectal Neoplasms
Walking
Feasibility Studies
Patient Satisfaction
Telephone
Counseling
Randomized Controlled Trials
Quality of Life
Exercise
Control Groups

Keywords

  • feasibility study
  • rectal cancer
  • neoadjuvant therapy
  • prehabilitation
  • surgery

Cite this

Moug, S. J. ; Mutrie, N. ; Barry, S. J. E. ; Mackay, G. ; Steele, R. J. C. ; Boachie, C. ; Buchan, C. ; Anderson, A. S. / Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration : results from The REx trial. In: Colorectal Disease. 2019 ; Vol. 21, No. 5. pp. 548-562.
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abstract = "Aim: Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) experience physical deterioration and reductions in their quality of life. This feasibility study assessed prehabilitation (a walking intervention) before, during and after NACRT to inform a definitive multi-centred randomized clinical trial (REx trial). Methods: Patients planned for NACRT followed by potentially curative surgery were approached (August 2014–March 2016) (www.isrctn.com; 62859294). Prior to NACRT, baseline physical and psycho-social data were recorded using validated tools. Participants were randomized to either the intervention group (exercise counselling session followed by a 13–17 week telephone-guided walking programme) or a control group (standard care). Follow-up testing was undertaken 1–2 weeks before surgery. Results: Of the 296 screened patients, 78 (26{\%}) were eligible and 48 (61{\%}) were recruited. N = 31 (65{\%}) were men with a mean age of 65.9 years (range 33.7–82.6). Mean intervention duration was 14 weeks with 75{\%} adherence. n = 40 (83{\%}) completed follow-up testing. Both groups recorded reductions in daily walking but the reduction was less in the intervention group although not statistically significant. Participants reported high satisfaction and fidelity to trial procedures. Conclusion: This study demonstrates that prehabilitation is feasible in rectal cancer patients undergoing NACRT. Good recruitment, adherence, retention and patient satisfaction rates support the development of a fully powered trial. The effects of the intervention on physical outcomes were promising.",
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Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration : results from The REx trial. / Moug, S. J.; Mutrie, N.; Barry, S. J. E.; Mackay, G.; Steele, R. J. C.; Boachie, C.; Buchan, C.; Anderson, A. S.

In: Colorectal Disease, Vol. 21, No. 5, 31.05.2019, p. 548-562.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration

T2 - Colorectal Disease

AU - Moug, S. J.

AU - Mutrie, N.

AU - Barry, S. J. E.

AU - Mackay, G.

AU - Steele, R. J. C.

AU - Boachie, C.

AU - Buchan, C.

AU - Anderson, A. S.

PY - 2019/5/31

Y1 - 2019/5/31

N2 - Aim: Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) experience physical deterioration and reductions in their quality of life. This feasibility study assessed prehabilitation (a walking intervention) before, during and after NACRT to inform a definitive multi-centred randomized clinical trial (REx trial). Methods: Patients planned for NACRT followed by potentially curative surgery were approached (August 2014–March 2016) (www.isrctn.com; 62859294). Prior to NACRT, baseline physical and psycho-social data were recorded using validated tools. Participants were randomized to either the intervention group (exercise counselling session followed by a 13–17 week telephone-guided walking programme) or a control group (standard care). Follow-up testing was undertaken 1–2 weeks before surgery. Results: Of the 296 screened patients, 78 (26%) were eligible and 48 (61%) were recruited. N = 31 (65%) were men with a mean age of 65.9 years (range 33.7–82.6). Mean intervention duration was 14 weeks with 75% adherence. n = 40 (83%) completed follow-up testing. Both groups recorded reductions in daily walking but the reduction was less in the intervention group although not statistically significant. Participants reported high satisfaction and fidelity to trial procedures. Conclusion: This study demonstrates that prehabilitation is feasible in rectal cancer patients undergoing NACRT. Good recruitment, adherence, retention and patient satisfaction rates support the development of a fully powered trial. The effects of the intervention on physical outcomes were promising.

AB - Aim: Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) experience physical deterioration and reductions in their quality of life. This feasibility study assessed prehabilitation (a walking intervention) before, during and after NACRT to inform a definitive multi-centred randomized clinical trial (REx trial). Methods: Patients planned for NACRT followed by potentially curative surgery were approached (August 2014–March 2016) (www.isrctn.com; 62859294). Prior to NACRT, baseline physical and psycho-social data were recorded using validated tools. Participants were randomized to either the intervention group (exercise counselling session followed by a 13–17 week telephone-guided walking programme) or a control group (standard care). Follow-up testing was undertaken 1–2 weeks before surgery. Results: Of the 296 screened patients, 78 (26%) were eligible and 48 (61%) were recruited. N = 31 (65%) were men with a mean age of 65.9 years (range 33.7–82.6). Mean intervention duration was 14 weeks with 75% adherence. n = 40 (83%) completed follow-up testing. Both groups recorded reductions in daily walking but the reduction was less in the intervention group although not statistically significant. Participants reported high satisfaction and fidelity to trial procedures. Conclusion: This study demonstrates that prehabilitation is feasible in rectal cancer patients undergoing NACRT. Good recruitment, adherence, retention and patient satisfaction rates support the development of a fully powered trial. The effects of the intervention on physical outcomes were promising.

KW - feasibility study

KW - rectal cancer

KW - neoadjuvant therapy

KW - prehabilitation

KW - surgery

U2 - 10.1111/codi.14560

DO - 10.1111/codi.14560

M3 - Article

VL - 21

SP - 548

EP - 562

JO - Colorectal Disease

JF - Colorectal Disease

SN - 1463-1318

IS - 5

ER -