# The role of prehabilitation in improving brain health and cognition after chemotherapy in patients with colorectal cancer: Study protocol of the Chemo Brain Prehab Project

## TL;DR

This study explores if prehabilitation can improve brain health and reduce cognitive issues in colorectal cancer patients undergoing chemotherapy.

## Contribution

The study introduces a home-based prehabilitation program to address chemotherapy-related cognitive impairments in colorectal cancer patients.

## Key findings

- Patients will be randomized into prehabilitation or standard care groups to assess cognitive outcomes.
- The study will measure biomarkers, brain activity, and cognitive function before and after chemotherapy.
- Results may inform accessible prehabilitation strategies to mitigate cognitive side effects of treatment.

## Abstract

Regional disparities in the incidence of colorectal cancer remain a concern within the United Kingdom, particularly in the North West of England, with 37% higher incidences than the national average. Given the growing burden of treatment-related side effects such as cognitive impairment, this study aims to investigate whether prehabilitation can improve brain health and cognitive function in patients with colorectal cancer receiving adjuvant and neoadjuvant chemotherapy.

This randomised control trial will recruit eighty-six patients with stage II and III colorectal cancer, who will receive adjuvant and neoadjuvant chemotherapy (fluorouracil, capecitabine, or oxaliplatin) and will be randomised between prehabilitation and standard care groups. The prehabilitation group will be provided an individualised, home-based exercise programme before and during chemotherapy, multivitamin supplementation, telephone check-ins, and activity devices. The standard care group will be provided with information about physical activity and nutrition at the start of the intervention. Habitual physical activity will be tracked in all patients. Assessments will be conducted at baseline, 72 hours before the first chemotherapy administration, and 72–96 hours after the final treatment. Outcome measures will include cardiopulmonary fitness, neurotrophic biomarkers, electroencephalographic activity, cognitive function tests, and a cognitive-related quality of life assessment.

This study protocol is designed to test whether home-based prehabilitation can improve brain health and reduce chemotherapy-related cognitive impairments in patients with colorectal cancer. Insights from this work may support the development of more accessible and effective prehabilitation programmes to address treatment specific cognitive impairment.

ClinicalTrials.gov NCT07341217