Feasibility of an Aerobic Exercise Intervention in Rectal Cancer Patients During and After Neoadjuvant Chemoradiotherapy
Bibliographic record
Abstract
Standard treatment for locally advanced rectal cancer includes 5-6 weeks of neoadjuvant chemoradiotherapy (NACRT) followed by definitive surgery 6-8 weeks later. NACRT improves outcomes but is also associated with substantial toxicity and side effects including declines in physical fitness that may impede symptom management, treatment response and post-surgical recovery. PURPOSE: The primary purpose of this phase I study was to assess the feasibility and safety 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 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 post-NACRT. Feasibility was determined by eligibility rate, recruitment rate, follow-up rate and exercise adherence. Safety was assessed by tracking any serious adverse events that occurred during exercise testing or the supervised exercise sessions. Health-related fitness 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%) were recruited. Follow-up rates post-NACRT were 83% for health-related fitness outcomes and 94% for patient-reported outcomes. Patients attended a median of 83% of their supervised exercise sessions and completed an average of 222 ± 155 minutes/week of their unsupervised exercise. No serious adverse events were observed. Most health-related fitness 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 feasible and safe for rectal cancer patients during and after NACRT. Phase II randomized trials are needed to establish the benefits and harms of aerobic exercise in this patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".