Multimodal prehabilitation to enhance functional capacity of patients with esophageal cancer during concurrent neoadjuvant chemotherapies—a randomized feasibility trial
Bibliographic record
Abstract
Esophageal adenocarcinoma continues to bear high morbidity and mortality. Prehabilitation, using exercise, nutrition, and psychosocial strategies to optimize patients prior to surgical resection, is largely underexplored in this malignancy, especially in patients undergoing neoadjuvant chemotherapy. Objectives of this study were (i) to determine feasibility of prehabilitation during treatment in patients with esophageal cancer and (ii) to establish differences between hospital and home-based exercise. Patients were recruited from August 2019 - February 2023 and blindly randomized to either supervised or homebased exercise, receiving identical nutritional and psychosocial support. The main outcome measures were recruitment, retention, and dropout rates. The secondary outcomes included cardiorespiratory fitness, functional capacity, and quality of life. Forty-four subjects were blindly randomized: 23 to supervised exercise and 21 to home-based exercise (72% recruitment rate). Overall compliance for the supervised group was 72%; home-based group was 77%. Baseline to pre-operative, both groups experienced significant increases in sit-to-stand, arm curls, and amount of weekly moderate-vigorous physical activity. The home-based group experienced an additional considerable decrease in up-and-go test times. Both groups maintained cardiorespiratory fitness and saw substantial increases in some quality-of-life scores. Multimodal prehabilitation is feasible for patients with esophageal cancer undergoing neoadjuvant chemotherapy. In both groups, patient fitness, which is relevant for this patient population given the anticipated decline in functional status during this period, was maintained. This study provides a foundation for future prehabilitation interventions in this patient population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.000 | 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 teacher head, 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".