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Maintaining Fitness During Neo-adjuvant Chemotherapy for Oesophago-gastric Cancer: a Feasibility Study

Not Applicable
Conditions
Esophageal Adenocarcinoma
Gastric Adenocarcinoma
Interventions
Other: ChemoFit exercise prehabilitation intervention
Registration Number
NCT04194463
Lead Sponsor
Newcastle-upon-Tyne Hospitals NHS Trust
Brief Summary

Feasibility study to investigate the utility of a simple, home-based, exercise intervention during and after neo-adjuvant chemotherapy but prior to surgery for esophageal and gastric adenocarcinoma.

Detailed Description

The principle aim of this study is to test the feasibility of utilising a home-based 'prehabilitation' exercise regimen in oesophago-gastric patients during preoperative chemotherapy and the period leading up to surgical resection. The investigators also hope to explore secondary outcomes of such a regimen, such as maintenance of fitness, the incidence of sarcopenia, muscle function and the outcomes of therapy. The investigators will explore the added value of blood-borne frailty biomarkers to objectively measure changes in physiology during neo-adjuvant chemotherapy (NAC). This will be tested using CPET, CT measured sarcopenia, grip strength and a small panel of biomarkers as secondary outcome and exploratory measures. Thus the main question is: 'Will patients participate in a home-based exercise programme during and after NAC for oesophago-gastric cancer?'

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Operable adenocarcinoma of the oesophagus, oesophago-gastric junction and stomach (locally advanced adenocarcinoma with planned preoperative chemotherapy, T3+, T1/2 N+)
  • Planned preoperative chemotherapy with ECX, ECX variant or FLOT chemotherapy
  • Age >18
  • Ability to complete CPET
  • Ability to consent to study and carry out the planned intervention.
Exclusion Criteria
  • Standard contraindications to CPET testing as defined by ATS Guidance
  • Orthopaedic limitations to CPET and / or daily exercise, for example, amputation, severe knee or hip disease.
  • Inoperable cancer at initial screening MDT
  • Planned non-surgical treatment with either radiotherapy or combined chemoradiotherapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
ChemoFit exercise prehabilitation interventionChemoFit exercise prehabilitation interventionExercise intervention consisting of walking and increasing daily step count. This is monitored by wearing a pedometer device. Other part of intervention are 5 simple strengthening exercises.
Primary Outcome Measures
NameTimeMethod
Recruitment rate1 year

Defined as the proportion of all patients approached that agree to enter the study.

Individual compliance1 year

With the intervention, defined as the percentage of intervention days when the patient was wearing his/her pedometer, was contactable every week and was recording his/her daily step count.

Completion rate1 year

Defined as the proportion of all patients that enter the study that remain participants at the end of the defined study period (at surgery).

Secondary Outcome Measures
NameTimeMethod
Sarcopenia1 year

Change in grip strength

Outcome of oncology treatment1 year

Admissions to hospital with chemotherapy induced toxicity

Step count1 year

Change in daily step count from pedometer each day

Quality of life1 year

Quality of life using QLQ-C30 and QLQ-OG25 questionnaires

CPET measurements1 year

Cardiopulmonary fitness measured by cardiopulmonary exercise testing.

End of study questionnaire1 year

Subjective perception of intervention using questionnaire

Focus group1 year

End of study 'PPI' focus group to assess exercise intervention

Trial Locations

Locations (1)

Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust

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Newcastle Upon Tyne, Tyne And Wear, United Kingdom

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