Fit4Chemo: feasibility and effectiveness of a multimodal revalidation program in patients with stage 3 colon carcinoma prior and during adjuvant chemotherapy

In the Netherlands, each year 5,000 people are diagnosed with colon carcinoma
with lymph node metastases. These so-called stage 3 colon carcinoma patients
require adjuvant chemotherapy to improve survival rates. If this adjuvant
chemotherapy cannot be started in time or cannot be fully completed, 5-year
survival rates decrease from 75% to 39%. Due to the high risk of complications
after surgery (approximately 30-60%), postoperative recovery is often delayed.
As a result, in only 50% of patients adjuvant chemotherapy is started in time.
Moreover, 50% of the patients undergoing adjuvant chemotherapy drop out or
receive a dose reduction due to side effects. Research has shown that
optimizing the condition by a multimodal program prior to surgery
(prehabilitation) increases a patient*s resilience to withstand surgery. As a
results, postoperative complication rates decrease and functional recovery
enhances. By analogy, it can be suggested that a comparable program after
surgery both ensures patients to start chemotherapy in time and ensures
patients to better tolerate adjuvant chemotherapy.

This pilot study will be performed to determine the feasibility and
effectiveness of a multimodal revalidation program prior to and during adjuvant
chemotherapy in patients with stage 3 colon carcinoma.

This pilot study will be conducted in Noordwest Ziekenhuisgroep location
Alkmaar. 15-20 patients with stage 3 colon carcioma eligible for treatment with
adjuvant chemotherapy will be included. Included patients will undergo a
multimodal revalidation program including high intensity interval training
prior to and during adjuvant chemotherapy.

Patients will undergo a multimodal revalidation program prior to and during
adjuvant chemotherapy. Patients will perform high intensity interval training
and resistance training under supervision of a physiotherapist. The content of
the training will be adjusted to a patient's condition and can be adjusted
throughout the revalidation program. Physiotherapists are trained to anticipate
complex problems in patients with cancer. The high intensity of this
revalidation program might be considered as a burden for the patients. However,
we know from prehabilitation, in which patiens undergo a training program with
similar intensity, that increasing their fitness is of such value that patients
do not perceive the high intensity as a high load.