T105 - Physical Activity at Diagnosis Is Associated with Tumor Response in Patients with Rectal Cancer

Tuesday, June 4, 2024

8:16 AM – 8:22 AM ET, USA

Location: Room 314-317

Abstract Podium Presenter(s)

Isa Mast, MSc

PhD candidate
Radboud University Medical Center, Department of medical BioSciences
MSc
Nijmegen, Gelderland, Netherlands

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.

Author(s)

Hd

Hans de Wilt, n/a

Professor of Surgical Oncology
Radboud University Medical Center, Department of Surgical Oncology
Nijmegen, Gelderland, Netherlands

Disclosure information not submitted.
BD

Berfin Duman, MSc

Internship Health Sciences
Radboud University Medical Center, department of Medical BioSciences
Arnhem, Gelderland, Netherlands

Disclosure information not submitted.
KS

Karel Smit, MD

PhD candidate
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands
Utrecht, Utrecht, Netherlands

Disclosure information not submitted.
EG

Elske Gootjes, MD PhD

Medical Oncologist
Radboud University Medical Center, Department of Medical Oncology
Gelderland, Gelderland, Netherlands

Disclosure information not submitted.
PV

Pauline Vissers, PhD

Researcher
Radboud University Medical Center, Department of Surgical Oncology
Nijmegen, Gelderland, Netherlands

Disclosure information not submitted.
HR

Heidi Rutten, MSc

Radiation Oncologist
Radboudumc University Medical Center, Department of Radiation Oncology
Elst, Gelderland, Netherlands

Disclosure information not submitted.
IN

Iris D. Nagtegaal, MD PhD

Chair of Gastrointestinal Pathology
Radboud University Medical Center, Department of Pathology
Nijmegen, Gelderland, Netherlands

Disclosure information not submitted.
MH

Maria Hopman, Prof. Dr.

Professor physiology
Radboud University Medical Center, Department of Medical BioSciences
NIjmegen, Gelderland, Netherlands

Disclosure information not submitted.
AM

Anne May, PhD

Clinical Epidemiologist
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht
Utrecht, Utrecht, Netherlands

Disclosure information not submitted.

Senior Author(s)

LB

Laurien Buffart, PhD

Research group leader
Radboud University Medical Center, Department of Medical BioSciences
Nijmegen, Gelderland, Netherlands

Disclosure information not submitted.

Purpose/Background: Standard treatment for patients with locally advanced rectal cancer is neoadjuvant chemoradiation (NCRT), followed by a waiting period and surgical resection. Good or complete response to NCRT might enable organ preservation. Consequently, strategies to increase response rates are needed. Pre-clinical studies suggest mechanisms by which physical activity during NCRT may improve tumor response. Therefore, we aimed to investigate whether physical activity (PA) and physical function (PF) of patients with rectal cancer prior to the start of NCRT are associated with tumor response.

Methods/Interventions: Data from the Dutch Prospective Colorectal Cancer Cohort (PLCRC) was used for this study. Patients who received NCRT for rectal cancer and completed the questionnaires on physical activity (SQUASH) and physical function (EORTC QLQ-C30 subscale) between 1 month prior and 2 weeks after the start of NCRT were included in the analyses. Patients were classified into three clinical stages at diagnosis: low risk (cT1-3XN0), intermediate risk (cT1-3XN1), and high risk (cT4 or cN2) tumors. After restaging post NCRT, tumor response was dichotomized into a complete/good tumor response (a complete response or downstaging two risk levels) or a moderate/bad response (progression, no change, or downstaging only one risk level). PA data was divided into tertiles of total physical activity and moderate-to-vigorous physical activity (MVPA) in hours per week. Dutch PA guideline adherence (yes/no) and PF (good/poor) were dichotomized. Logistic regression analyses were performed to examine associations of physical activity and physical function with tumor response, adjusted for age, sex, BMI, primary clinical stage, smoking, and alcohol consumption.

Results/Outcomes: 272 patients (aged 62 ± 11 years, 33.6% female) with rectal cancer were included. The proportion of patients with a complete/good response was 54% in the low MVPA group, 67% in the moderate MVPA group, and 64% in the high MVPA group. Patients in the moderate MVPA group (OR = 2.14; 95% CI = 1.12 – 4.24; p = 0.024) or high MVPA group (OR = 2.03; 95% CI = 1.06 – 4.11; p = 0.038) were more likely to have a complete/good tumor response than patients in the low MVPA group. No significant associations with tumour response were found for total PA, Dutch PA guideline adherence, and physical function.

Conclusion/Discussion: Using data from a large prospective national cohort study, we found a better tumor response in patients with rectal cancer who reported moderate-high MVPA levels before the start of NCRT compared to patients who reported low MVPA levels. Causality needs to be confirmed in future trials investigating the effects of exercise interventions.