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Exercise Prehabilitation in Patients With Head and Neck Squamous-cell Carcinoma: The FIT4TREAT Trial

Not Applicable
Recruiting
Conditions
Head and Neck Neoplasms
Interventions
Other: Prehabilitation
Registration Number
NCT05418842
Lead Sponsor
Associacao de Investigacao de Cuidados de Suporte em Oncologia
Brief Summary

The main purpose of this randomized-controlled trial is to evaluate the effects of prehabilitation based on exercise training (ET) on functional capacity in HNC patients treated with chemoradiotherapy (CRT). Forty-six participants will be randomized (1:1 ratio) into prehabilitation and usual care groups. The length of intervention will be at least 2 weeks. Data will be collected at diagnosis, immediately before anti-cancer treatment start and 4 weeks following CRT. Primary outcome is functional capacity as assessed by the six-minute walk test. Additional measures include muscle strength, endothelial function, arterial stiffness, inflammatory biomarkers, body composition, quality of life, treatment tolerance, compliance to treatment, progression-free survival, and overall survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Age ≥18 years old;
  • Histologically confirmed HNSCC located on the oral cavity, larynx, oropharynx, hypopharynx, nasopharynx or in lymph nodes from an unknown primary tumor (stage I-IV);
  • Proposed for concomitant chemoradiotherapy with curative intent;
  • Date of treatment beginning ≥2 weeks from baseline assessment;
  • ECOG-Performance Status 0-1.
Exclusion Criteria
  • Completion of previous anticancer treatment within less than a year;
  • Uncontrolled hypertension, cardiac or pulmonary disease;
  • Contraindications to exercise training;
  • Inability to provide informed consent;
  • Expected inability to fulfil the proposed schedule.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Prehabilitation GroupPrehabilitationIn addition to standard medical care, the prehabilitation group will have three supervised exercise training sessions per week from diagnosis to start of radiotherapy (pre-treatment phase).
Primary Outcome Measures
NameTimeMethod
Functional CapacityChange from Baseline (at diagnosis) to 1-3 days before the beginning of radiotherapy

Assessed by six-minute walk test.

Secondary Outcome Measures
NameTimeMethod
Functional CapacityChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by six-minute walk test.

Unplanned hospital visitsFrom baseline to 4 Weeks after last radiotherapy session
Compliance to ChemotherapyThrough chemotherapy completion, an average of 7 weeks

Assessed as the average relative chemotherapy dose-intensity received for the originally planned regimen based on standard formulas.

Compliance to RadiotherapyThrough radiotherapy completion, an average of 7 weeks

Assessed assessed as the completion of prescribed dose of radiation during the prescribed time frame.

Overall SurvivalFrom baseline to 5 years after diagnosis

Defined as the time from randomization to death from any cause.

Arterial StiffnessChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by carotid-femoral pulse wave velocity.

Endothelial FunctionChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by brachial artery dilation to endothelial-dependent stimuli using an ultrasound, according to the recommendations.

Lower Limb FunctionalityChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by 30-second sit to stand test.

Health-related Quality of LifeChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). This is a patient-reported questionnaire composed of both multi-item scales and single-item measures. These include 5 functional scales, 3 symptom scales, a global health status / QoL scale, and 6 single items. All of the scales and single-item measures range in score from 0 to 100. A high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status/QoL represents a high QoL, but a high score for a symptom scale/item represents a high level of symptomatology/problems.

Body WeightChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by bioelectrical impedance.

Percentage of Body FatChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by bioelectrical impedance.

C-Reactive ProteinChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session
AlbuminChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session
HemogramChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session
Isometric Handgrip Muscle StrengthChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by hand dynamometer.

Head and Neck Cancer-specific Quality of LifeChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-HN43). This is the head and neck cancer specific module that contains 43 questions with 19 symptoms scales. All of the multi-item scales and single-item measures range in score from 0 to 100. A high score represents a high level of symptomatology or problems.

Muscle MassChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by bioelectrical impedance.

Body Mass IndexChange from 1-3 days before the beginning of radiotherapy to 4 Weeks after last radiotherapy session

Assessed by participant's weight in kilograms divided by the square of height in meters.

Treatment-Related Adverse EventsFrom the beginning of radiotherapy/chemotherapy to 4 Weeks after last radiotherapy session

Assessed by CTCAE-vs.5.

Progression-Free SurvivalFrom baseline to 5 years after diagnosis

Defined as the time from randomization to the occurrence of disease progression or death.

Trial Locations

Locations (5)

University of Maia

🇵🇹

Maia, Porto, Portugal

Liga Portuguesa Contra o Cancro - Núcleo Regional do Norte (LPCC-NRN)

🇵🇹

Porto, Portugal

Instituto Português de Oncologia do Porto (IPO-Porto)

🇵🇹

Porto, Região, Portugal

University of Aveiro

🇵🇹

Aveiro, Portugal

Centro Hospitalar Vila Nova de Gaia/Espinho

🇵🇹

Vila Nova De Gaia, Porto, Portugal

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