Brown Malcolm, O'Connor Dominic, Turkington Richard, Eatock Martin, Vince Rebecca, Hulme Claire, Bowdery Roy, Robinson Rebecca, Wadsley Jonathan, Maraveyas Anthony, Prue Gillian
School of Nursing and Midwifery, Queen's University Belfast Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, UK.
School of Health Sciences, The University of Nottingham, Nottingham, England, UK.
BMC Sports Sci Med Rehabil. 2023 Sep 21;15(1):116. doi: 10.1186/s13102-023-00722-3.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive neoplasm, with surgical resection and adjuvant chemotherapy the only curative treatment. Treatment-related toxicities place a considerable burden on patients although exercise training has shown promise is helping to manage such adversities and facilitate rehabilitation. The feasibility and safety of exercise training as a supportive therapy during adjuvant chemotherapy remains unknown.
Patients with PDAC were screened post-surgical resection and enrolled in a 16-week, progressive, concurrent exercise programme alongside their chemotherapy regimen. Feasibility was the primary objective detailing recruitment, retention and adherence rates throughout as well as the safety and fidelity of the intervention. Secondarily, the impact on functional fitness and patient-reported outcomes was captured at baseline, post-intervention and 3-month follow up.
Eight patients consented to participate in this trial, with five proceeding to enrol in exercise training. Concurrent exercise training is feasible and safe during adjuvant chemotherapy and prevented an expected decline in functional fitness and patient-reported outcomes during this time.
This case series provides preliminary evidence that concurrent exercise training during adjuvant therapy is safe, feasible and well tolerated, preventing an expected decline in functional fitness, muscular strength and health-related quality of life (HRQoL). Given the adverse effects of treatment, these findings are promising and provide further evidence for the inclusion of exercise training as a standard of care for surgical rehabilitation and managing treatment-related toxicities. Future research should explore the impact of exercise training during neoadjuvant chemotherapy, with prehabilitation now standard practice for borderline resectable disease.
ClinicalTrials.gov Identifier: NCT04305067, prospectively registered 12/03/2020, https://classic.
gov/ct2/show/NCT04305067 .
胰腺导管腺癌（PDAC）是一种侵袭性肿瘤，手术切除和辅助化疗是唯一的治愈性治疗方法。尽管运动训练已显示出有助于应对这些不良反应并促进康复，但治疗相关的毒性给患者带来了相当大的负担。辅助化疗期间运动训练作为一种支持性治疗的可行性和安全性仍不清楚。
对PDAC患者进行术后筛查，并在其化疗方案的同时参加为期16周的渐进性同步运动计划。可行性是主要目标，详细说明整个过程中的招募、保留和依从率以及干预的安全性和保真度。其次，在基线、干预后和3个月随访时记录对功能适应性和患者报告结果的影响。
8名患者同意参加本试验，其中5名继续参加运动训练。辅助化疗期间同步运动训练是可行且安全的，并在此期间防止了功能适应性和患者报告结果的预期下降。
本病例系列提供了初步证据，表明辅助治疗期间同步运动训练是安全、可行且耐受性良好的，可防止功能适应性、肌肉力量和健康相关生活质量（HRQoL）的预期下降。鉴于治疗的不良反应，这些发现很有前景，并为将运动训练纳入手术康复和管理治疗相关毒性的标准护理提供了进一步证据。未来的研究应探索新辅助化疗期间运动训练的影响，目前对于可切除边缘的疾病，术前康复是标准做法。
ClinicalTrials.gov标识符：NCT04305067，2020年3月12日前瞻性注册，https://classic.
gov/ct2/show/NCT04305067 。
