Physical activity at diagnosis is associated with tumor downstaging after neoadjuvant chemoradiotherapy in patients with rectal cancer.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 39265927 · doi:10.1016/j.radonc.2024.110523
What was done
Analyzed 268 patients with rectal cancer (mean age 62 ± 11 years, 33% female) from the prospective Dutch Prospective ColoRectal Cancer Cohort who received neoadjuvant chemoradiotherapy. Baseline physical activity (total, moderate-to-vigorous physical activity [MVPA], and Dutch guideline adherence) and physical functioning were measured using self-reported questionnaires. Multivariable logistic regression evaluated associations with tumor downstaging (dichotomized into good/complete vs. moderate/poor), adjusting for confounders.
What was found
Patients with moderate (OR = 2.07; 95% CI = 1.07–4.07; p = 0.03) or high (OR = 2.05; 95% CI = 1.05–4.07; p = 0.04) levels of MVPA had significantly greater odds of good/complete tumor downstaging compared to those with low levels. No significant associations were observed for total physical activity, guideline adherence, or physical functioning.
Why it matters
These findings suggest that pre-treatment moderate-to-vigorous physical activity is associated with improved tumor response, supporting the exploration of exercise interventions to enhance organ-preservation strategies in rectal cancer.
Limits
Physical activity was self-reported via questionnaires rather than objectively tracked, introducing potential reporting and recall bias. As an observational cohort study, causality cannot be established and residual confounding remains possible; activity during or after treatment was not reported.
Cited by
- partial Cancer patients who exercise while undergoing chemoradiation therapy are more likely to achieve a complete pathological response prior to surgery.