NCT01325909

Brief Summary

Neoadjuvant chemoradiotherapy (NACRT) prior to surgery for lower gastrointestinal (colon and rectal) cancer is associated with improved survival, but also adversely affects physical fitness, potentially rendering patients unfit for major surgery or increasing the risk of adverse outcome (death and serious complications) after major surgery. The investigators have pilot data using an upper gastrointestinal cancer patient cohort showing that neoadjuvant chemotherapy (NAC)reduces objectively measured exercise capacity (fitness). The investigators therefore propose a blinded, single centre, prospective interventional trial of patients undergoing NACRT prior to elective colorectal cancer resection in an NHS teaching hospital. The investigators wish to explore various hypotheses:

  1. 1.Is exercise intervention feasible and tolerable in this cohort of patients?
  2. 2.Can fitness be improved using a structured, responsive exercise training programme (SRETP)?
  3. 3.Can SRETP improve quality of life?
  4. 4.Can SRETP improve physical activity?
  5. 5.Can SRETP improve surgical outcome?
  6. 6.Can physiological fitness and oncological outcome be matched to identify an optimal time for physiological recovery following NACRT prior to major surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
35

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Mar 2011

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2011

Completed
28 days until next milestone

First Submitted

Initial submission to the registry

March 29, 2011

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 30, 2011

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2014

Completed
Last Updated

April 7, 2014

Status Verified

April 1, 2014

Enrollment Period

3.1 years

First QC Date

March 29, 2011

Last Update Submit

April 4, 2014

Conditions

Outcome Measures

Primary Outcomes (1)

  • Maintain or improve physical fitness (anaerobic threshold measured by CPET)after treatment with neoadjuvant chemoradiotherapy in colorectal cancer patients.

    3 years

Secondary Outcomes (6)

  • Other measures of physical fitness measured in CPET or the VO2 kinetics test

    3 years

  • Adherence to a 6 week interval exercise intervention.

    3 years

  • Optimal time for surgery indicating optimal oncological and physiological fitness

    3 years

  • Health related quality of life improvement as measured by SF36, EORCT c30 v3

    3 years

  • Outcome from major surgery measured by 5 day POMS

    3 years

  • +1 more secondary outcomes

Study Arms (2)

Exercise

ACTIVE COMPARATOR
Behavioral: Exercise programme

No Exercise

NO INTERVENTION

Interventions

Exercise

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • All patients listed to undergo elective colorectal cancer resection and longcourse neoadjuvant chemoradiotherapy at Aintree University Hospitals NHS Foundation Trust

You may not qualify if:

  • Unable to consent
  • Under 18 years of age
  • Unable to perform exercise
  • Meet any contraindications on the ATS CPET safety guidelines

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Aintree University Hospitals

Liverpool, L9 7AL, United Kingdom

Location

Related Publications (4)

  • Loughney L, West MA, Dimitrov BD, Kemp GJ, Grocott MP, Jack S. Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study. Perioper Med (Lond). 2017 Feb 16;6:3. doi: 10.1186/s13741-017-0058-3. eCollection 2017.

  • Brunet J, Burke S, Grocott MP, West MA, Jack S. The effects of exercise on pain, fatigue, insomnia, and health perceptions in patients with operable advanced stage rectal cancer prior to surgery: a pilot trial. BMC Cancer. 2017 Feb 23;17(1):153. doi: 10.1186/s12885-017-3130-y.

  • West MA, Dimitrov BD, Moyses HE, Kemp GJ, Loughney L, White D, Grocott MP, Jack S, Brown G. Timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer - A comparison of magnetic resonance imaging at two time points and histopathological responses. Eur J Surg Oncol. 2016 Sep;42(9):1350-8. doi: 10.1016/j.ejso.2016.04.003. Epub 2016 Apr 26.

  • West MA, Loughney L, Lythgoe D, Barben CP, Sripadam R, Kemp GJ, Grocott MP, Jack S. Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study. Br J Anaesth. 2015 Feb;114(2):244-51. doi: 10.1093/bja/aeu318. Epub 2014 Oct 1.

MeSH Terms

Conditions

Rectal Neoplasms

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesIntestinal DiseasesRectal Diseases

Study Officials

  • Malcolm A West, MD MRCS

    Aintree University Hospitals NHS Foundation Trust, Liverpool, UK

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Research and Development Director

Study Record Dates

First Submitted

March 29, 2011

First Posted

March 30, 2011

Study Start

March 1, 2011

Primary Completion

April 1, 2014

Study Completion

April 1, 2014

Last Updated

April 7, 2014

Record last verified: 2014-04

Locations