Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2023 Aug;17(4):1171-1183.
doi: 10.1007/s11764-021-01149-w. Epub 2021 Nov 29.

Effects of exercise during and after neoadjuvant chemoradiation on symptom burden and quality of life in rectal cancer patients: a phase II randomized controlled trial

Andria R Morielli  1 , Normand G Boulé  1 , Nawaid Usmani  2 , Keith Tankel  2 , Kurian Joseph  2 , Diane Severin  2 , Alysa Fairchild  2 , Tirath Nijjar  2 , Kerry S Courneya  3
Affiliations
Clinical Trial

Effects of exercise during and after neoadjuvant chemoradiation on symptom burden and quality of life in rectal cancer patients: a phase II randomized controlled trial

Andria R Morielli et al. J Cancer Surviv. 2023 Aug.

Abstract

Purpose: We previously demonstrated that exercise during and after neoadjuvant chemoradiation (NACRT) for rectal cancer may improve the rate of pathologic complete/near complete response. Here, we report the effects of exercise on symptom management and quality of life (QoL).

Methods: Rectal cancer patients (N = 36) were randomized to a supervised high-intensity interval training program during NACRT followed by unsupervised continuous exercise after NACRT or usual care. Patient-reported outcomes were assessed at baseline, post-NACRT, and presurgery including symptom burden (M.D. Anderson Symptom Inventory) and QoL (European Organisation for Research and Treatment of Cancer QLQ- C30 and -CR29).

Results: During NACRT, exercise significantly worsened stool frequency (adjusted between-group difference, 25.8; 95% CI, 4.0 to 47.6; p = 0.022), role functioning (adjusted between-group difference, -21.3; 95% CI, -41.5 to -1.1; p = 0.039), emotional functioning (adjusted between-group difference, -11.7; 95% CI, -22.0 to -1.4; p = 0.028), and cognitive functioning (adjusted between-group difference, -11.6; 95% CI, -19.2 to -4.0; p = 0.004) compared to usual care. After NACRT, exercise significantly worsened diarrhea (adjusted between-group difference, 1.2; 95% CI, 0.1 to 2.3; p = 0.030) and embarrassment (adjusted between-group difference, 19.7; 95% CI, 7.4 to 32.1; p = 0.003) compared to usual care.

Conclusions: Exercise exacerbated some symptoms and worsened QoL during NACRT; however, most negative effects dissipated after NACRT. Larger trials are necessary to confirm these findings.

Implications for cancer survivors: If the clinical benefit of exercise is confirmed, then the modest symptom exacerbation during NACRT may be considered tolerable. However, in the absence of any clinical benefit, exercise may be contraindicated in this clinical setting.

Keywords: Chemotherapy; Exercise; Quality of life; Radiotherapy; Rectal neoplasms.

PubMed Disclaimer

References

    1. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731–40. https://doi.org/10.1056/NEJMoa040694 . - DOI - PubMed
    1. Bosset JF, Collette L, Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med. 2006;355(11):1114–23. https://doi.org/10.1056/NEJMoa060829 . - DOI - PubMed
    1. Gerard JP, Conroy T, Bonnetain F, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3–4 rectal cancers: Results of FFCD 9203. J Clin Oncol. 2006;24(28):4620–5. https://doi.org/10.1200/JCO.2006.06.7629 . - DOI - PubMed
    1. Ellis CT, Samuel CA, Stitzenberg KB. National trends in nonoperative management of rectal adenocarcinoma. J Clin Oncol. 2016;34(14):1644–51. https://doi.org/10.1200/JCO.2015.64.2066 . - DOI - PubMed
    1. O’Gorman C, Denieffe S, Gooney M. Literature review: Preoperative radiotherapy and rectal cancer - impact on acute symptom presentation and quality of life. J Clin Nurs. 2014;23(3–4):333–51. https://doi.org/10.1111/jocn.12138 . - DOI - PubMed

Publication types

LinkOut - more resources