Patients who are receiving chemotherapy for oesophageal cancer may benefit from exercise therapy, researchers report today.
Neoadjuvant chemotherapy, given to shrink the tumour in advance of surgery, can decrease patient fitness, according to a team led by Dr Andrew Davies at Guy’s and St Thomas’ Hospitals NHS Trust, London, UK.
They looked at the potential benefits of the use of exercise for oesophageal cancer patients in a trial of 40 patients given either a structured prehabilitation course of exercise during neoadjuvant chemotherapy, or conventional treatment.
The exercise intervention or ‘prehab’ programme was based on a moderate intensity programme in line with World Health Organisation recommended levels of physical activity for adults aged 18 to 64 years. It incorporated aerobic exercise and strength training.
Patients received training sessions and were provided with written and diagrammatic instructions on how to continue the exercise programme at home.
Analysis showed that the exercise group had significantly higher rates of tumour shrinkage. They also showed reduced markers of inflammation.
In *British Journal of Sports Medicine* today, the researchers write: "The results from this prospective trial suggest there may be novel and important clinical benefits of a structured exercise programme.
"Perhaps most importantly there is some evidence, although in a small group of patients, of improved pathological, radiological and immunological responses to chemotherapy in the exercise Intervention group."
They add: “Tumour downstaging and response to chemotherapy are arguably the most important prognostic factors in oesophageal cancer.
"That structured exercise programmes might contribute to improved cancer regression, possibly through enhanced immunological and/or inflammatory modulation, is potentially clinically significant.”
Zylstra, J. et al. Exercise prehabilitation during neoadjuvant chemotherapy may enhance tumour regression in oesophageal cancer: results from a prospective non randomised trial. *British Journal of Sports Medicine* 2 February 2022; doi: 10.1136/bjsports-2021-104243
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