Impact of Neoadjuvant Chemotherapy on Physical Fitness, Physical Activity, and Health-related Quality of Life of Patients With Resectable Esophageal Cancer

Objective: Neoadjuvant chemotherapy (NAC) followed by radical surgery is the standard treatment for patients with resectable esophageal squamous cell carcinoma (ESCC) in Japan. However, some adverse events associated with NAC may result in a decrease in physical fitness that may influence the patient's ability to tolerate surgery. The purpose of this study was to evaluate the impact of NAC on physical fitness, physical activity, and health-related quality of life (HRQOL) of patients with ESCC. Methods: In this prospective study, we investigated 27 consecutive patients with newly diagnosed resectable ESCC who were scheduled to receive NAC followed by surgery between January 2009 and November 2010. Primary endpoints were change from baseline in physical fitness (knee extensor muscle strength and 6-min walking distance) and physical activity after NAC. A secondary endpoint was change from baseline in HRQOL. Results: Physical fitness and physical activity level after NAC did not differ significantly from those before NAC. With regard to HRQOL, only social functioning was significantly different (P = 0.04). The change in physical activity demonstrated a significant correlation with the change in 6-minute walking distance (r = 0.45, P = 0.02). Conclusions: NAC had no impact on physical fitness and physical activity in patients with ESCC. This result indicated that there was no need for a physiotherapy intervention during NAC to prevent a decline in these parameters.