Feasibility of early multimodal interventions for elderly patients with advanced pancreatic and non-small-cell lung cancer.
- Naito T Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
- Mitsunaga S Department of Hepatobilliary and Pancreatic Oncology, National Cancer Center Hospital East, Chiba, Japan.
- Miura S Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.
- Tatematsu N Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan.
- Inano T Division of Nutrition, Shizuoka Cancer Center, Shizuoka, Japan.
- Mouri T Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
- Tsuji T Division of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
- Higashiguchi T Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine, Aichi, Japan.
- Inui A Pharmacological Department of Herbal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
- Okayama T Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan.
- Yamaguchi T Division of Nutrition, Kyushu University Hospital, Kyushu, Japan.
- Morikawa A Division of Nursing, Shizuoka Cancer Center, Shizuoka, Japan.
- Mori N Palliative Care Center, Aichi Medical University, Aichi, Japan.
- Takahashi T Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
- Strasser F Oncological Palliative Medicine, Clinic Oncology and Hematology, Department of Internal Medicine, Cantonal Hospital, St. Gallen, Switzerland.
- Omae K Department of Clinical Biostatistics, Kyoto University, Kyoto, Japan.
- Mori K Division of Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
- Takayama K Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
- 2018-10-19
Published in:
- Journal of cachexia, sarcopenia and muscle. - 2019
Cancer cachexia
Elderly
Multimodal intervention
Non-small-cell lung cancer
Pancreatic cancer
Physical activity
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
Exercise Therapy
Feasibility Studies
Female
Humans
Lung Neoplasms
Male
Muscle, Skeletal
Nutrition Assessment
Nutrition Therapy
Pancreatic Neoplasms
Physical Fitness
English
BACKGROUND
Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme.
METHODS
This was a multicentre prospective single-arm study. We recruited 30 of 46 screened patients aged ≥70 years scheduled to receive first-line chemotherapy for newly diagnosed, advanced pancreatic, or non-small-cell lung cancer. Physical activity was measured using pedometers/accelerometer (Lifecorder® , Suzuken Co., Ltd., Japan). An 8 week educational intervention comprised three exercise and three nutritional sessions. The exercise interventions combined home-based low-intensity resistance training and counselling to promote physical activity. Nutritional interventions included standard nutritional counselling and instruction on how to manage symptoms that interfere with patient's appetite and oral intake. Supplements rich in branched-chain amino acids (Inner Power® , Otsuka Pharmaceutical Co., Ltd., Japan) were provided. The primary endpoint of the study was feasibility, which was defined as the proportion of patients attending ≥4 of six sessions. Secondary endpoints included compliance and safety.
RESULTS
The median patient age was 75 years (range, 70-84). Twelve patients (40%) were cachectic at baseline. Twenty-nine patients attended ≥4 of the six planned sessions (96.7%, 95% confidence interval, 83.3 to 99.4). One patient dropped out due to deteriorating health status. The median proportion of days of compliance with supplement consumption and exercise performance were 99% and 91%, respectively. Adverse events possibly related to the NEXTAC programme were observed in five patients and included muscle pain (Grade 1 in two patients), arthralgia (Grade 1 in one patient), dyspnoea on exertion (Grade 1 in one patient), and plantar aponeurositis (Grade 1 in one patient).
CONCLUSIONS
The early induction of multimodal interventions showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. We are now conducting a randomized phase II study to measure the impact of these interventions on functional prognosis.
Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme.
METHODS
This was a multicentre prospective single-arm study. We recruited 30 of 46 screened patients aged ≥70 years scheduled to receive first-line chemotherapy for newly diagnosed, advanced pancreatic, or non-small-cell lung cancer. Physical activity was measured using pedometers/accelerometer (Lifecorder® , Suzuken Co., Ltd., Japan). An 8 week educational intervention comprised three exercise and three nutritional sessions. The exercise interventions combined home-based low-intensity resistance training and counselling to promote physical activity. Nutritional interventions included standard nutritional counselling and instruction on how to manage symptoms that interfere with patient's appetite and oral intake. Supplements rich in branched-chain amino acids (Inner Power® , Otsuka Pharmaceutical Co., Ltd., Japan) were provided. The primary endpoint of the study was feasibility, which was defined as the proportion of patients attending ≥4 of six sessions. Secondary endpoints included compliance and safety.
RESULTS
The median patient age was 75 years (range, 70-84). Twelve patients (40%) were cachectic at baseline. Twenty-nine patients attended ≥4 of the six planned sessions (96.7%, 95% confidence interval, 83.3 to 99.4). One patient dropped out due to deteriorating health status. The median proportion of days of compliance with supplement consumption and exercise performance were 99% and 91%, respectively. Adverse events possibly related to the NEXTAC programme were observed in five patients and included muscle pain (Grade 1 in two patients), arthralgia (Grade 1 in one patient), dyspnoea on exertion (Grade 1 in one patient), and plantar aponeurositis (Grade 1 in one patient).
CONCLUSIONS
The early induction of multimodal interventions showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. We are now conducting a randomized phase II study to measure the impact of these interventions on functional prognosis.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1002/jcsm.12351
- PMID 30334618
- Persistent URL
- https://sonar.ch/global/documents/278340
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