Department of Dietetics, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, Netherlands.
Eur J Cancer Care (Engl). 2022 Nov;31(6):e13662. doi: 10.1111/ecc.13662. Epub 2022 Aug 11.
Chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with high toxicity that adversely affects physical functioning, body composition, fatigue, quality of life and treatment outcomes. Exercise interventions during treatment might counteract these negative effects. We therefore assessed the feasibility of an exercise programme for HNC patients during CRT.
Forty patients were offered a tailored 10-week endurance and resistance training with supervised and home-based sessions. Feasibility endpoints were (1) adherence (main outcome): ≥60% attendance; (2) recruitment: ≥30%; (3) retention rate: ≥85% and (4) compliance rate: ≥60%. Physical performance, muscle strength, body composition, quality of life and fatigue were assessed pre- and post-intervention.
Overall adherence was 54%. The recruitment rate was 36%, and the retention rate was 65%. Compliance to the supervised intervention protocol was 66%. Statistically significant decreases were found in mean grip strength, fat-free mass and clinically relevant deteriorations on several domains of quality of life, and fatigue subscales were found.
We conclude that this exercise programme for HNC patients during CRT in its current form is feasible for only a minority of patients. We suggest adaptations to improve adherence and retention rates for a definitive multicentre trial.
This study is registered at the Netherlands Trial Register (NTR7305), 6 June 2018, retrospectively registered.
头颈部癌症（HNC）的放化疗（CRT）会带来较高的毒性，从而对身体功能、身体成分、疲劳、生活质量和治疗结果产生不利影响。治疗过程中的运动干预可能会抵消这些负面影响。因此，我们评估了在 CRT 期间对头颈癌患者进行运动计划的可行性。
40 名患者接受了为期 10 周的耐力和阻力训练，包括监督和家庭训练。可行性终点包括：（1）依从性（主要结局）：≥60%的出勤率；（2）招募率：≥30%；（3）保留率：≥85%；（4）依从率：≥60%。干预前后评估了身体机能、肌肉力量、身体成分、生活质量和疲劳情况。
总体依从率为 54%。招募率为 36%，保留率为 65%。监督干预方案的依从率为 66%。握力、去脂体重以及生活质量的多个领域和疲劳亚量表的临床相关恶化程度均显著降低。
我们得出结论，目前这种针对 CRT 期间头颈癌患者的运动计划，仅对少数患者是可行的。我们建议进行调整，以提高依从性和保留率，从而开展一项确定的多中心试验。
该研究在荷兰试验注册库（NTR7305）注册，注册日期为 2018 年 6 月 6 日，为回顾性注册。
