Key result
Preoperative long course chemoradiotherapy significantly reduced cardiopulmonary fitness, evidenced by a decline in peak oxygen consumption (VO2peak), without clinically important associations to changes in body composition or inflammatory markers.
Why the study?
Neoadjuvant cancer therapy prior to surgery may reduce fitness and increase perioperative risk, but the mechanisms reducing functional capacity were not fully understood.
Does neoadjuvant therapy reduce functional capacity and alter body composition in patients with advanced rectal cancer?
Cohort (n=36)
No
Does neoadjuvant therapy reduce functional capacity and alter body composition in patients with advanced rectal cancer?
Neoadjuvant chemoradiotherapy for rectal cancer significantly reduces cardiopulmonary fitness, but this decline is not correlated with changes in body composition or systemic inflammation.
Answers are grounded in this paper and cite their sources.
Neoadjuvant chemoradiotherapy may reduce preoperative fitness in rectal cancer; leaves open whether prehabilitation improves outcomes.
Background: Rectal cancer treatment with neoadjuvant radiotherapy or chemoradiotherapy (NAT) prior to anaesthesia and surgery may reduce fitness and so increase perioperative risk. Understanding the mechanisms by which NAT reduces functional capacity will inform the development of preoperative risk reduction strategies such as prehabilitation. We hypothesized that the effects of NAT are mediated through the inflammatory response and changes in body composition with loss of muscle.
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Burke et al. (2020) conducted a cohort in Advanced rectal cancer (n=36). Neoadjuvant therapy (long course chemoradiotherapy or short course radiotherapy) vs. Baseline (pre-treatment) was evaluated on Peak oxygen consumption (VO2peak) in the long course chemoradiotherapy group (median change -1.0 ml kg-1 min-1, p=0.005). Preoperative long course chemoradiotherapy significantly reduced cardiopulmonary fitness, evidenced by a decline in peak oxygen consumption (VO2peak), without clinically important associations to changes in body composition or inflammatory markers.
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