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Prehabilitation for patients undergoing neoadjuvant treatment: results of a single-center pilot study using an
Svenja Klaus-Karwisch1, Stephanie Otto2,3,4,5,6, Paul Georg Werthmann1
1Section Integrative Medicine, Department of General and Visceral Surgery, Ulm University Medical Center, Ulm University, Ulm, Germany.
Introduction:
Oncological prehabilitation aims to strengthen cancer patients physically and mentally before treatment, yet it is not standard care. The Prehabilitation through an Integrative Medicine Day Clinic (PRIME-DC) study examined the feasibility of a multimodal program during neoadjuvant therapy prior to surgery.
Material And Methods:
In this single-arm, mono-center interventional feasibility trial, patients attended a closed-group program once weekly for eight weeks (6.5-hour sessions) scheduled across the neoadjuvant treatment period. The curriculum integrated physical exercise, nutritional and naturopathic counseling, and Mind-Body Medicine practices. The primary outcome was program adherence, defined by attendance rate. Secondary outcomes included patient-reported measures of quality of life, anxiety, depression, fatigue, sleep, mindfulness, and physical fitness tests assessed at baseline and post-intervention. Patient satisfaction were evaluated at program completion.
Results:
Twenty-three of the 41 patients who were assessed for eligibility were enrolled, with an adherence rate of 69%. An exploratory within-group improvement in the 1-minute sit-to-stand test was observed from baseline to post-intervention (V1: 26.00 (22.00/34.00), V10a: 27.00 (24.99/34.00), 95% CI = 1.000 - 6.000, p = 0.02, r = 0.66), while other functional and patient-reported outcomes showed no statistically detectable within-group changes (p > 0.05). No study-related adverse events occurred. Patient satisfaction was assessed using a 17-item Likert scale (0-4). Overall, patients reported high levels of satisfaction (range: 0.00 - 1.88).
Conclusion:
This pilot feasibility study provides preliminary evidence that participation in an integrative prehabilitation day-clinic program may be associated with the preservation of physical and mental health during neoadjuvant treatment. The findings indicate good feasibility and acceptability, providing a strong rationale for further investigation in larger, controlled trials.
Clinical Trial Registration:
https://drks.de/search/de/trial/DRKS00028126, identifier DRKS00028126.