Simon Lea Haverbeck, Saviers-Steiger Carson, Dunston Emily R, Galyean Patrick, Kimball Elisabeth R, Mendez Justine, Zickmund Susan L, Hansen Pamela A, Ulrich Cornelia M, LaStayo Paul C, Steinberg David, Noren Christopher S, Finch A'Lisha, Seckinger Leanne, Braun Emma, Chipman Jonathan, Brownson Kirstyn E, Oza Sonal, Coletta Adriana M
Cancer Control and Population Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA.
The Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA.
Cancer. 2025 May 1;131(9):e35798. doi: 10.1002/cncr.35798.
This pilot, mixed-methods, randomized controlled trial determined the feasibility and acceptability of the Comprehensive Oncology Rehabilitation and Exercise (CORE) clinical workflow algorithm. CORE was designed to connect patients with newly diagnosed breast cancer to exercise and rehabilitation services from the time of diagnosis throughout cancer care.
In total, 72 patients with newly diagnosed, stage I-III breast cancer who required surgery as first-line treatment were randomized 2:1 to CORE or standard of care. CORE included a triaging tool of two questionnaires regarding self-reported exercise (the Godin Leisure Time physical activity questionnaire) and functional status (the Patient-Reported Outcomes Measurement Information System physical function questionnaire), which were administered at the check-in desk for routine breast surgical oncology clinic visits at the initial surgical consultation, postoperatively, and 24 weeks after surgery. Responses to questionnaires in the triaging tool triaged participants to one of three pathways within the algorithm: exercise service, rehabilitation service, or exercise self-management (not a service). Service pathways required referral by clinic staff. Feasibility was determined based on completing the triaging tool (≥66%) and referral completion (≥50%) at the initial surgical consultation visit. Acceptability was determined by four study participant focus groups and one clinic team focus group (≥50% positive response).
Ninety-three percent of participants in CORE (n = 40) completed the triaging tool. Among those triaged to a service pathway (n = 29), 62% completed their referral. Focus group feedback was primarily positive.
The CORE clinical workflow algorithm is feasible and acceptable among women who have newly diagnosed stage I-III breast cancer with plans for surgery as first-line treatment. CORE was also acceptable among clinic staff.
NCT04594473.
这项试点性、混合方法、随机对照试验确定了综合肿瘤康复与运动（CORE）临床工作流程算法的可行性和可接受性。CORE旨在从诊断之时起，在整个癌症治疗过程中，将新诊断出乳腺癌的患者与运动及康复服务联系起来。
共有72例需要手术作为一线治疗的新诊断为I - III期乳腺癌患者，按2:1随机分为CORE组或常规治疗组。CORE包括一个分诊工具，该工具由两份问卷组成，一份是关于自我报告运动情况的（戈丁休闲时间体力活动问卷），另一份是关于功能状态的（患者报告结局测量信息系统身体功能问卷），在初次手术咨询、术后以及术后24周的常规乳腺外科肿瘤门诊就诊时，在登记台发放。分诊工具中问卷的回答将参与者分为算法内的三种路径之一：运动服务、康复服务或运动自我管理（非服务）。服务路径需要诊所工作人员进行转诊。可行性根据初次手术咨询就诊时完成分诊工具（≥66%）和转诊完成情况（≥50%）来确定。可接受性由四个研究参与者焦点小组和一个诊所团队焦点小组确定（≥50%的积极反馈）。
CORE组中93%的参与者（n = 40）完成了分诊工具。在被分诊到服务路径的参与者中（n = 29），62%完成了转诊。焦点小组的反馈主要是积极的。
CORE临床工作流程算法对于计划将手术作为一线治疗的新诊断为I - III期乳腺癌的女性来说是可行且可接受的。CORE在诊所工作人员中也具有可接受性。
NCT04594473。
