391. PREHABILITATION DURING NACT IN ESOPHAGEAL CANCER CARE—A FEASIBILITY STUDY
Notice bibliographique
Résumé
Abstract Background Esophageal cancer bears a high disease burden with elevated morbidity and mortality. Treatment of esophageal adenocarcinoma (EAC) includes Neoadjuvant Chemotherapy (NACT) followed by surgical resection and subsequent adjuvant chemotherapy (ACT). This treatment triad effectively weakens already ill patients. Prehabilitation, a preoperative intervention designed to optimize patients through exercise, nutrition, and psychology, is understudied in this malignancy. Given limited prehabilitation resources at many hospitals, efficacy of home-based programs vs traditional supervised programs was investigated. Methods Patients diagnosed with EAC underwent a multimodal prehabilitation intervention and were blindly randomized to either supervised exercise or home-based exercise. The study was considered feasible if patients complied to 70% of the program. Compliance was measured by number of completed exercise sessions and adherence to nutritional advice and supplementation. Safety was measured by occurrence of adverse events. Cardiorespiratory fitness was measured by cardiopulmonary exercise testing (CPET). Functional capacity was measured by 6-minute walking test (6MWT), Sit-to-Stand and Hand Grip Strength. Quality of Life was measured by ESAS and FACT-E. All patients underwent assessment at baseline, preoperatively and 8 weeks postoperatively. Results 44 patients were enrolled, supervised (n = 23) and home-based (n = 21). Average age was 64, BMI 27.9 kg/m2 and 68% underwent an Ivor Lewis esophagectomy. There were no significant differences between groups at baseline. Overall adherence to the program by the supervised group was 72% and 77% by the home-based group. Exercise allocation was not linked to adherence (p = 0.45). There were 2 non-serious adverse events recorded during this trial: one bout of syncope and one of light headedness during exercise. There is a relative maintenance or even improvement of cardiorespiratory fitness, functional capacity and QoL during NACT throughout the preoperative period. Conclusion Prehabilitation is an effective and safe intervention in esophageal cancer patients undergoing NACT. Home-based programs seem to provide similar benefits to supervised programs. This allows for wider implementation of prehabilitation in hospitals which do not have dedicated outpatient clinics for this purpose. Buffering functional decline during treatment is a triumph in a population that usually suffers. However, larger trials investigating prehab’s effect on post operative complications and QoL are needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».