Feasibility And Preliminary Efficacy Of High-intensity Interval Training During Neaodjuvant Chemoradiotherapy For Rectal Cancer
Bibliographic record
Abstract
PURPOSE: To assess the feasibility, safety, and preliminary efficacy of a supervised high-intensity interval training (HIIT) program in rectal cancer patients undergoing 5-6 weeks of neoadjuvant chemoradiotherapy (NACRT). METHODS: Thirty-six rectal cancer patients scheduled to receive NACRT followed by surgery were randomized to either exercise training (n=18) or usual care (n=18) in the Exercise During and After Rectal Cancer Treatment (EXERT) Trial in Edmonton, Alberta. Patients in the exercise group were asked to complete 3 supervised HIIT sessions/week for the duration of NACRT. Feasibility was determined by eligibility rate, recruitment rate, follow-up rate and exercise adherence. Safety was assessed by tracking serious adverse events related to exercise. The primary efficacy outcome was cardiorespiratory fitness (VO2 peak) assessed immediately post-NACRT by a graded exercise test. Secondary efficacy outcomes included functional fitness assessed by the Senior’s Fitness Test. RESULTS: From June 2017 to August 2019, 205 rectal cancer patients were screened, 131 (64%) were eligible, and 36 (27%) were recruited. Follow-up fitness testing post-NACRT was completed in 75% (exercise n=14; control n=13). Reasons for missed fitness testing were medical issues. Median attendance for the supervised HIIT sessions during NACRT was 82%. No serious adverse events were observed, however, 2 patients in the exercise group experienced musculoskeletal events which resulted in 4 missed exercise sessions. Analyses of covariance showed no statistically significant or clinically meaningful difference between groups for the primary outcome of VO2 peak (adjusted between-group mean difference, 0.9 ml/kg/min; 95% CI, -1.6, 3.3; p = 0.47). The 8-foot up-and-go was significantly better in the exercise group post-NACRT (adjusted between group mean difference, -0.4 seconds; 95% CI, -0.7, 0.0, p = 0.031). No other significant group differences in functional fitness were observed. CONCLUSIONS: Supervised HIIT during NACRT for rectal cancer was feasible and safe. Further research is needed, however, to better understand the feasibility of completing fitness testing immediately following NACRT and whether HIIT can produce meaningful improvements in fitness in this challenging clinical setting.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".