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Published on: April 22, 2019
Exercise and quality of life in head and neck squamous cell carcinoma patients receiving neoadjuvant
Guoming Xiao1, Li Ning1, Lihui Chen1
1State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, China; Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
Background:
Head and neck squamous cell carcinoma (HNSCC) significantly impairs patients' quality of life (QoL). While neoadjuvant immuno-chemotherapy offers potential survival benefits, it is associated with substantial treatment-related toxicities, including fatigue, sleep disturbances, and functional decline. Exercise therapy has shown promise in improving QoL in other cancers, but its role in HNSCC patients receiving neoadjuvant therapy remains underexplored.
Methods:
This single-center, open-label, randomized phase II trial enrolled 114 HNSCC patients undergoing neoadjuvant immuno-chemotherapy. Participants were randomized 1:1 to an exercise group (personalized breathing and aerobic exercise program) or a control group (routine care). Outcomes were assessed using the BFI-C, EORTC QLQ-C30, QLQ-H&N35, and PSQI at baseline, after 2 cycles, and after 3 cycles of therapy.
Results:
The exercise group demonstrated significantly lower fatigue scores (BFI) after 2 and 3 cycles compared to controls (P < 0.05). Sleep quality (PSQI) improved significantly in the exercise group and worsened in the control group. The exercise group also showed better outcomes in physical functioning, fatigue and insomnia.
Conclusion:
Exercise therapy is feasible and effective in reducing fatigue and improving sleep quality in HNSCC patients receiving neoadjuvant immuno-chemotherapy. Early integration of exercise may mitigate treatment-related symptoms and improve tolerance and overall QoL.
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