# Prehabilitation during neoadjuvant therapy in patients with cancer of the upper gastrointestinal tract and rectum—the study protocol

## TL;DR

This study tests a prehabilitation program for cancer patients undergoing neoadjuvant therapy to improve their physical condition before surgery.

## Contribution

The study introduces a feasibility trial of a home-based prehabilitation program during neoadjuvant therapy for upper gastrointestinal and rectal cancer patients.

## Key findings

- The study will assess participation rates and completion of the prehabilitation program.
- Physical fitness and quality of life outcomes will be measured to evaluate the program's impact.
- Results will inform the design of future large-scale controlled trials.

## Abstract

The concept of prehabilitation, defined as interventions aimed at enhancing a patient's functional capacity prior to an impending physiological stressor, may contribute to reduced postoperative morbidity and mortality. The study's goal is to verify or refute the feasibility of a prehabilitation programme for two diagnostic patient groups during neoadjuvant chemo(radio)therapy, which is prescribed before the scheduled surgical procedure. This is a single group study design, with all patients enrolled receiving the intervention.

This is an interventional feasibility study of a prehabilitation programme in the form of physical training conducted at home. The training consists of progressively dosed walking and strength exercises for selected muscle groups. Data will be monitored telemetrically and also through telephone contact with participants. Primary outcomes include: the percentage of patients interested in participating in the study out of all patients indicated for neoadjuvant therapy at University Hospital Ostrava during the observed period, the percentage of patients who complete the prehabilitation programme until the date of surgery and individual patient compliance. Secondary outcomes include physical fitness parameters obtained from cardiopulmonary exercise testing, grip strength measured by a dynamometer, changes in body composition, EORTC QLQ-C30 quality of life questionnaire, and a questionnaire on the subjective perception of the exercise programme. Both primary and secondary outcomes will be compared between study arms (two diagnostic groups). The study is registered at ClinicalTrials.gov, ID: NCT05646043.

The results of this study can serve as a foundation for larger, multicentre, controlled studies in the future.