STEPTOE: Strengthening exercise prehabilitation during treatment of oesophagogastric cancer
Oesophagogastric adenocarcinoma
This study is a single centre, pilot, randomised control trial. Eligible patients from Salford Royal Hospital will be consulted and informed about the trial and if they consent will be randomised to either the control group or the intervention group. The randomisation will be independent, concealed and with use of Sealed envelope (https://www.sealedenvelope.com/). Randomisation will be stratified for age and sex. Participants and clinicians will be informed of the allocated treatment group following randomisation. Clinicians will not be blinded due to the need to remain astute to safety, adherence and side effects, which require open and honest discussions with patients at each appointment. Baseline strength and cardiovascular fitness assessments will be made, then the intervention period will start. Patients will be having their neoadjuvant chemotherapy during the intervention period. Once the chemotherapy treatment has ended there is another set of assessments. Then there is a recovery period for patients prior to surgery, 0-2 weeks prior to surgery the final set of assessments will take place. Participants will then resume normal care pathway. Control format [WesFit Protocol] Supervised HIIT training that will take place at MMU Plat Lane Sports Facilities. The exercise-training programme is consistent with the FITT-VP principle (frequency, intensity, time, type, volume and progression), as advised by a panel of international experts and patient representatives. The exercise intervention has been shown by our group to be safe, feasible and tolerable in cancer patients following neoadjuvant chemoradiotherapy. Patients will participate in a prescribed, supervised, aerobic high-intensity interval, structured, responsive, exercise training programme (SRETP) on an electronically-braked cycle ergometer. Participants will undertake an initial 5mintues of unloaded pedalling. This is followed by 3 minutes at moderate intensity and 2 minutes at severe intensity. Sever
1. 18 years old or older with locally advanced oesophageal, gastric or junctional adenocarcinoma (T2 N1 or above on initial composite staging) 2. Curative treatment pathway with neoadjuvant chemotherapy followed by surgery 3. Oesophagectomy by any approach including trial dissections or abandoned oesophagectomy. Gastrectomy by any approach including trial dissections or abandoned surgery. 4. WHO performance status </= 2
1. Squamous cell carcinoma 2. Palliative treatment pathway or development of unresectable disease during neoadjuvant treatment. 3. Treatment for recurrent oesophageal cancer or salvage treatment. 4. Synchronous malignancy elsewhere 5. Medically deemed unable to partake in resistance training program or study assessments due to significant musculoskeletal or mobility comorbidity. 6. Established neuromuscular diagnosis (inflammatory myopathy, idiopathic myositis) 7. Pregnancy 8. Unable to consent