<p>Exercise during adjuvant treatment for colorectal cancer: treatment completion, treatment-related toxicities, body composition, and serum level of adipokines</p>

Abstract

Objectives: The primary aim of this study was to investigate the beneficial effect of exercise on completion rates of adjuvant treatment, which is one of the major prognostic factors among patients with locally advanced colorectal cancer after undergoing curative resection followed by adjuvant treatment. Design: Prospective pilot study Methods: We assigned patients who were scheduled to undergo adjuvant treatment (N=39) to the exercise group or the control group in a 2:1 ratio in the order of enrollment. Patients completed questionnaires and underwent assessment of the outcome variables at the start of chemotherapy and upon completion of treatment. Results: A fivefold lower possibility of dose adjustment in the exercise group compared to the control group was demonstrated (OR, 0.188; p =0.023; 95% CI, 0.044–0.793). A significantly smaller proportion of the exercise group had grade 3 or 4 nausea ( p =0.018) and neurotoxicity ( P =0.024) symptoms. Muscle to fat ratios were significantly reduced in the control group ( p =0.039), but not in the exercise group ( p =0.742). Serum levels of leptin were significantly increased in the control group ( p =0.038), but not in the exercise group ( p =0.073). Serum levels of adiponectin were significantly increased in the exercise group ( p =0.026) but tended to be decreased in the control group with no statistical significance ( p =0.418). Conclusions: Exercise training among patients with colorectal cancer was found to have a beneficial impact on adjuvant treatment completion rates and treatment-associated toxicities. This program was also shown to be beneficial to patients’ body compositions and serum levels of adipokines.

Circulating Leptin, Adiponectin, and Tumor Necrosis Factor-Alpha in Patients Undergoing Surgery Due to Colorectal Cancer

“…The third potential limitation of our study was that we did not analyze the endocrine function of skeletal muscles, the serum concentration of myokines, or the level of patients' physical activity, which seem to be important in the context of evidence concerning the role of cross-talk between adipose tissue and skeletal muscles. In addition, patients without sarcopenia have a better prognosis [56], and lower LEP and higher ADP blood concentrations have been recorded in patients during adjuvant treatment for CRC who were allocated to an exercise training program compared to a control group [57]. However, we found that a lower IADL score, which may be recognized as a surrogate parameter of sarcopenia, was an independent factor determining the survival of patients after surgery (Table 3).…”

Effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy—a pilot study

“…In fact, to our knowledge, only five controlled trials have explored the effects of aerobic and resistance exercise specifically in CRC patients undergoing adjuvant chemotherapy. All five studies involved relatively small sample sizes (12-45 patients) and a combined aerobic and resistance exercise program [18][19][20][21][22]. Improvements in fatigue, physical function, role function, pain, nausea, neurotoxicity symptoms, and physical activity levels have been observed [18,20,22].…”

“…All five studies involved relatively small sample sizes (12-45 patients) and a combined aerobic and resistance exercise program [18][19][20][21][22]. Improvements in fatigue, physical function, role function, pain, nausea, neurotoxicity symptoms, and physical activity levels have been observed [18,20,22]. Preliminary evidence also suggests beneficial effects of exercise on chemotherapy completion rates in CRC patients [22].…”

Evaluation of a Post-Operative Rehabilitation Program in Patients Undergoing Laparoscopic Colorectal Cancer Surgery: A Pilot Study

“…A consistent number of trials reported beneficial effects of physical exercise in patients treated for colorectal cancer, but the interventions are often administered during and/or after adjuvant treatment, many weeks or months after surgery [ 11 ]. Literature addressing the role of the rehabilitation after surgery is less consistent and the optimal exercise during the early survivorship stage of colorectal cancer is still unknown [ 51 ].…”