Does prehabilitation modify muscle mass in patients with rectal cancer undergoing neoadjuvant therapy? A subanalysis from the REx randomised controlled trial

Moug, Susan; Barry, Sarah; Maguire, Susan; Johns, Neil; Dolan, Daniel R.; Steele, Robert; Buchan, C.; MacKay, Graham J; Anderson, Annie S.; Mutrie, Nanette

doi:10.1007/s10151-020-02262-1

Cited by 31 publications

(36 citation statements)

References 33 publications

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“…Sarcopenic compared with non-sarcopenic participants, unsupervised, personalized, 6-month physical activity intervention with activity tracker showed significant changes in muscle cross-sectional area, skeletal muscle ratio density, lean body mass and malondialdehyde [ 12 ]. In a telephone-guided graduated walking program that lasted 13–17 weeks, 65% of patients in the pre-rehabilitation group maintained or increased their muscle mass, while 35% experienced a decrease [ 13 ]. While there was less than 50% prevalence of sarcopenia at baseline in any of the trials, it is evident that guided walking for 3 to 4 months improved sarcopenia characteristics in patients with cancer.…”

Section: Resultsmentioning

confidence: 99%

Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review

Supriya

Singh

et al. 2021

Biology

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Background: Sarcopenia has been recognized as an inevitable part of aging. However, its severity and the age at which it begins cannot be predicted by age alone. The condition can be categorized into primary or age-related sarcopenia and secondary sarcopenia. Sarcopenia is diagnosed as primary when there are no other specific causes. However, secondary sarcopenia occurs if other factors, including malignancy or organ failure, are evident in addition to aging. The prevalence of secondary sarcopenia is far greater than that of primary sarcopenia and requires special attention. To date, nutrition and exercise have proven to be the best methods to combat this disease. The impact of exercise on subjects suffering from sarcopenia with a specific morbidity is worthy of examination for understanding and prevention. The purpose of this review, therefore, is to summarize recent research that has investigated the impact of exercise in patients with secondary sarcopenia, specifically with one comorbidity. Methods: Pubmed, Web of Science, Embase and Medline databases were searched comprehensively with no date limit for randomized controlled trials. The literature was specifically searched for clinical trials in which subjects were sarcopenic with only one comorbidity participating in an exercise intervention. The most visible comorbidities identified and used in the search were lung disease, kidney disease, heart disease, type 2 diabetes, cancer, neurological diseases, osteoporosis and arthritis. Results: A total of 1752 studies were identified that matched the keywords. After removing duplicates, there were 1317 articles remaining. We extracted 98 articles for full screening. Finally, we included 21 relevant papers that were used in this review. Conclusion: Despite a strong rationale for using exercise to improve muscle mass, quality or physical function in subjects with cancer, type 2 diabetes, kidney disease, lung disease and many more, baseline sarcopenia evaluation has been reported in very few trials. The limited number of studies does not allow us to conclude that exercise can improve sarcopenia in patients with other comorbidities. This review highlights the necessity for wide-ranging research initiatives involving secondary sarcopenic patients.

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Section: Resultsmentioning

confidence: 99%

Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review

Supriya

Singh

et al. 2021

Biology

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“…After removing duplicates, 542 abstracts from PubMed and CENTRAL, and 36 trial records from ClinicalTrials.gov were screened, and 510 studies and 31 trial records were excluded based on inclusion criteria (Figure 1). Among the 34 full-text studies reviewed, seven exercise trials were considered eligible [23][24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

“…Among the seven included studies, four were RCTs [23,25,26,28], though one of these was a pilot study [25]. The other three were quasi-experimental studies; two were singlecohort experimental interventions [24,29] and one was a non-randomized trial [27].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies measured total lean body mass or appendicular lean mass via DEXA, and further estimated SMI or ASMI [23,25,26] (Table 1). Three studies employed CT to estimate muscle mass, two of them calculated SMI [27,29], and one used total psoas index (TPI) [28]. Finally, Yamamoto et al used BIA measured muscle mass, handgrip strength and GS for sarcopenic status of participants [24].…”

Section: Measurement and Diagnostic Criteria For Sarcopeniamentioning

confidence: 99%

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Effect of Exercise on Sarcopenia among Cancer Survivors: A Systematic Review

Cao

Ferrucci

Caan

et al. 2022

Cancers

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Sarcopenia is related to adverse health outcomes in cancer survivors. Previous reviews reported exercise improved muscle mass or function in cancer survivors, but thus far a systematic review examining the effect of exercise on sarcopenia in this population has not been conducted. Therefore, we systematically searched PubMed, CENTRAL (Cochrane Central Register of Controlled Trials) and ClinicalTrials.gov for publications and ongoing trials (through November 2021) that reported exercise interventions and diagnosed sarcopenia among cancer survivors. Seven exercise trials were eligible for this review. Six of seven studies showed exercise increased skeletal muscle post intervention (1.6% to 5.4% increase within intervention groups compared to baseline, p ≤ 0.07; 2.1% to 12.8% greater increase for intervention than control groups, p ≤ 0.02) and in the three studies that reported sarcopenia reversal, an improvement (18.2% to 42.9% decrease in sarcopenia in exercise groups, 5.2% increase to 16.7% decrease in sarcopenia in control groups, p = 0.04) was observed. Existing research indicates the potential for exercise to improve health outcomes for cancer survivors through building muscle and attenuating sarcopenia. More high-quality, long-term, large randomized controlled trials examining effects of different exercise types and doses to improve sarcopenia should be conducted to further explore this important topic.

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“…Another possible solution for diminishing toxicity rates during chemoradiation with capecitabine is the use prehabilitation programs. Promising results of the benefits of prehabilitation and exercise programs for rectal cancer patients undergoing chemoradiation treatment are emerging [32][33][34]. Targeting treatment on subgroups which have most advantage from it will eventually make prehabilitation programs more sufficient and cost-effective.…”

Section: Discussionmentioning

confidence: 99%

Relation between body composition and severe diarrhea in patients treated with preoperative chemoradiation with capecitabine for rectal cancer: a single-centre cohort study

Rees

Nuyttens

et al. 2021

BMC Gastroenterol

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Background Chemoradiation with capecitabine followed by surgery is standard care for locally advanced rectal cancer (LARC). Severe diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiation therapy. The aim of this study was to describe the risk factors and the impact of body composition on severe diarrhea in patients with LARC during preoperative chemoradiation with capecitabine. Methods A single centre retrospective cohort study was conducted in a tertiary referral centre. All patients treated with preoperative chemoradiation with capecitabine for LARC from 2009 to 2015 were included. Patients with locally recurrent rectal cancer who received chemoradiation for the first time were included as well. Logistic regression analyses were performed to identify risk factors for severe diarrhea. Results A total of 746 patients were included. Median age was 64 years (interquartile range 57–71) and 477 patients (64%) were male. All patients received a radiation dosage of 25 × 2 Gy during a period of five weeks with either concomitant capecitabine administered on radiation days or continuously during radiotherapy. In this cohort 70 patients (9%) developed severe diarrhea. In multivariable logistic regression analyses female sex (OR: 4.42, 95% CI 2.54–7.91) and age ≥ 65 (OR: 3.25, 95% CI 1.85–5.87) were the only risk factors for severe diarrhea. Conclusions Female patients and patients aged sixty-five or older had an increased risk of developing severe diarrhea during preoperative chemoradiation therapy with capecitabine. No relation was found between body composition and severe diarrhea.

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Does prehabilitation modify muscle mass in patients with rectal cancer undergoing neoadjuvant therapy? A subanalysis from the REx randomised controlled trial

Cited by 31 publications

References 33 publications

Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review

Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review

Effect of Exercise on Sarcopenia among Cancer Survivors: A Systematic Review

Relation between body composition and severe diarrhea in patients treated with preoperative chemoradiation with capecitabine for rectal cancer: a single-centre cohort study

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