Effect of Structured Exercise-based rehabilitation on Sarcopenia and Quality of life among Head and Neck Cancer Patients Undergoing Chemo-radiotherapy: A Randomized Controlled Trial.

Q2 Medicine

Asian Pacific Journal of Cancer Prevention Pub Date : 2025-05-01 DOI:10.31557/APJCP.2025.26.5.1653

Cherishma D'Silva, Vijith Shetty, Donald Fernandes, Baeyen Jean-Pierre, Suchetha Kumari N, Saumya Srivastava, Stephen Rajan Samuel

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引用次数: 0

Abstract

Background: Sarcopenia is considered an independent prognostic factor for overall survival and performance status in head and neck cancer (HNC) receiving chemo-radiotherapy (CRT). CRT is known to cause sleep disturbances, increased pain perception, depression leading to reduced quality of life (QOL). Exercise-based rehabilitation has emerged as a promising strategy for improving outcomes in HNC. Our study aimed to evaluate effect of exercise on sarcopenia and QOL in patients with HNC receiving CRT.

Methodology: Seventy HNC patients, aged 40-70 years TNM stage III- IVb receiving CRT, were randomized into two groups and received intervention for seven weeks. Intervention Group, IG (n=40) received combined aerobic and resistance training according to the ACSM guidelines. Control Group, CG (n=40) were advised to walk according to the NCCN guidelines. Sarcopenia was assessed using Bio Impedance Analyser (BIA), muscle strength using JAMAR hand dynamometer and QOL by FACT H&N on pre CRT day 1 and post 7 weeks. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess within-group differences and between-group comparisons respectively.

Results: 80 participants with a mean age of 58.44 ±3.75 years were included. IG showed a smaller decrease in total skeletal muscle mass compared to CG with IGs total skeletal muscle mass decreasing from 35 to 30 and CGs muscle mass decreasing from 40 to 21 (p<0.001). QOL showed significant improvement in CG from 66 to 61 (p < 0.001). In contrast, IGs quality of life saw a minor, non-significant change from 62 to 61.

Conclusion: Sarcopenia was lesser in IG compared to CG, highlighting the favourable impact of resistance training and its inclusion in the HNC rehabilitation. However, CG demonstrated significant improvements in quality of life as compared to IG suggesting that quality of life is a multifaceted construct that may not be directly correlated with physical improvements alone.

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一项随机对照试验：结构化运动康复对头颈癌化疗患者肌肉减少症和生活质量的影响。

背景：骨骼肌减少症被认为是头颈癌（HNC）接受化疗（CRT）患者总体生存和表现状态的独立预后因素。CRT会导致睡眠障碍，疼痛感增加，抑郁导致生活质量下降。以运动为基础的康复已成为改善HNC预后的一种有希望的策略。我们的研究旨在评估运动对接受CRT的HNC患者肌肉减少症和生活质量的影响。方法：将70例40 ~ 70岁接受CRT治疗的TNM III- IVb期HNC患者随机分为两组，分别进行7周的干预。干预组IG （n=40）按照ACSM指南进行有氧和阻力联合训练。对照组，CG （n=40）建议按照NCCN指南行走。在CRT前第1天和第7周，用生物阻抗分析仪（BIA）评估肌肉减少症，用JAMAR手测力仪评估肌肉力量，用FACT H&N评估生活质量。采用Wilcoxon sign -rank检验和Mann-Whitney U检验分别评价组内差异和组间比较。结果：入组80例，平均年龄58.44±3.75岁。IG组骨骼肌总骨骼肌质量下降幅度小于CG组，IG组骨骼肌总骨骼肌质量从35降至30，CG组骨骼肌质量从40降至21 (p)结论：与CG组相比，IG组骨骼肌减少症的发生率较低，突出了阻力训练及其在HNC康复中的有利影响。然而，与IG相比，CG在生活质量方面表现出了显著的改善，这表明生活质量是一个多方面的结构，可能并不仅仅与身体改善直接相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Pacific Journal of Cancer Prevention 医学-肿瘤学

CiteScore

2.80

自引率

0.00%

发文量

779

审稿时长

3 months

期刊介绍： Cancer is a very complex disease. While many aspects of carcinoge-nesis and oncogenesis are known, cancer control and prevention at the community level is however still in its infancy. Much more work needs to be done and many more steps need to be taken before effective strategies are developed. The multidisciplinary approaches and efforts to understand and control cancer in an effective and efficient manner, require highly trained scientists in all branches of the cancer sciences, from cellular and molecular aspects to patient care and palliation. The Asia Pacific Organization for Cancer Prevention (APOCP) and its official publication, the Asia Pacific Journal of Cancer Prevention (APJCP), have served the community of cancer scientists very well and intends to continue to serve in this capacity to the best of its abilities. One of the objectives of the APOCP is to provide all relevant and current scientific information on the whole spectrum of cancer sciences. They aim to do this by providing a forum for communication and propagation of original and innovative research findings that have relevance to understanding the etiology, progression, treatment, and survival of patients, through their journal. The APJCP with its distinguished, diverse, and Asia-wide team of editors, reviewers, and readers, ensure the highest standards of research communication within the cancer sciences community across Asia as well as globally. The APJCP publishes original research results under the following categories: -Epidemiology, detection and screening. -Cellular research and bio-markers. -Identification of bio-targets and agents with novel mechanisms of action. -Optimal clinical use of existing anti-cancer agents, including combination therapies. -Radiation and surgery. -Palliative care. -Patient adherence, quality of life, satisfaction. -Health economic evaluations.