Ikeda Tomohiro, Noma Kazuhiro, Konuma Masanori, Maeda Naoaki, Tanabe Shunsuke, Kawabata Takayoshi, Kanai Masashi, Hamada Masanori, Fujiwara Toshiyoshi, Ozaki Toshifumi
Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan.
Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan.
Esophagus. 2025 Apr;22(2):177-187. doi: 10.1007/s10388-025-01108-9. Epub 2025 Feb 4.
Physical activity has the potential to promote tumor regression in patients with esophageal cancer receiving neoadjuvant chemotherapy (NAC); however, the benefits of light-intensity physical activity (LIPA) are unclear. This study aimed to investigate the impact of LIPA on tumor regression in male patients with esophageal cancer during NAC and its optimal cutoff value.
This retrospective single-center observational study included all male patients who underwent NAC or curative esophagectomy. We assessed the physical activity of patients using an accelerometer and calculated the time spent on LIPA. Tumor regression was defined as grade ≥ 1b according to the Japanese classification of esophageal cancer. The impact of LIPA on tumor regression was analyzed using multivariate analysis, and the optimal cutoff value was identified using the receiver operating characteristic curve.
Sixty-nine male patients with esophageal cancer who underwent NAC were analyzed. The mean age was 68 years, mean body mass index was 22.4, and 80% of the patients were diagnosed with clinical stage 3 or 4 disease. Every extra 30-min increase in LIPA during the treatment phase was associated with tumor regression (adjusted OR 1.41 [1.02-2.04]). The optimal cutoff value of LIPA was 156.11 min/day, and patients with rich LIPA (≥ 156.11 min/day) were less likely to suffer from anorexia and malnutrition during NAC.
This study demonstrated that LIPA during NAC has a potential of promoting tumor regression with a cutoff value of 156.5 min/day. Further clinical research is required to determine the prognostic benefits of LIPA in patients receiving NAC.
体育活动有可能促进接受新辅助化疗（NAC）的食管癌患者的肿瘤消退；然而，低强度体育活动（LIPA）的益处尚不清楚。本研究旨在调查LIPA对男性食管癌患者在NAC期间肿瘤消退的影响及其最佳临界值。
这项回顾性单中心观察性研究纳入了所有接受NAC或根治性食管切除术的男性患者。我们使用加速度计评估患者的体育活动，并计算在LIPA上花费的时间。根据日本食管癌分类，肿瘤消退定义为≥1b级。使用多变量分析分析LIPA对肿瘤消退的影响，并使用受试者工作特征曲线确定最佳临界值。
分析了69例接受NAC的男性食管癌患者。平均年龄为68岁，平均体重指数为22.4，80%的患者被诊断为临床3期或4期疾病。治疗阶段LIPA每增加30分钟与肿瘤消退相关（调整后的OR为1.41[1.02-2.04]）。LIPA的最佳临界值为156.11分钟/天，LIPA丰富（≥156.11分钟/天）的患者在NAC期间患厌食症和营养不良的可能性较小。
本研究表明，NAC期间的LIPA有促进肿瘤消退的潜力，临界值为156.5分钟/天。需要进一步的临床研究来确定LIPA对接受NAC患者的预后益处。
