Trinity College, Dublin, Ireland
Emer M. Guinan , Suzanne Doyle , Linda O'Neill , Jacintha O'Sullivan , Prof John V Reynolds , Juliette M. Hussey
Background: Esophageal cancer is an examplar model of complex cancer care with defined quality of life (QOL) consequences. While prognosis for this aggressive disease is poor, survival is slowly improving leading to the emergence of a unique group of cancer survivors with complex rehabilitation needs. The ReStOre trial will implement a multi-disciplinary programme to improve functional performance and QOL for esophageal cancer survivors. This pilot work examines the feasibility of the proposed intervention. Methods: This study was a single-arm feasibility study. Patients who had completed curative treatment for esophageal cancer including esophagectomy and who had node-negative post-surgical pathology received a letter of invitation to participate. The programme consisted of 12 weeks supervised and home-based exercise, dietetic counselling and education sessions from the multi-disciplinary team. Feasibility outcomes included recruitment rates, adherence, adverse events and retention. Other outcomes, including cardiopulmonary fitness (maximal cardiopulmonary exercise test and six minute walk test (6MWT)), QOL (EORTC questionnaire) and body composition (bioimpedence analysis), were assessed pre- and post-intervention. Results: Twelve participants (mean (standard deviation (SD) age 61.4 (7.29) years, 8 male) consented to participate, representing a recruitment rate of 55%. Mean class attendance was 82% and mean adherence to the home exercise programme was 118%. No adverse events occurred and all participants completed programme. Aerobic fitness improved by 3.71(2.7) ml/kg/min (19.0 ml/kg/min pre-intervention, 22.7 ml/kg/min post-intervention, p < 0.001). 6MWT distance improved by 56.3 (35.3)m (p < 0.001). Global and functional QOL scores increased while symptom scores decreased. Body composition remained stable. Conclusions: The ReStOre trial demonstrated high feasibility and acceptability in this complex cohort. Improvements in functional performance and QOL were evident without compromise to body composition. While current results are limited due to the selected population and single-arm design they will guide the design of the forthcoming larger randomised controlled trial.
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