Exercise prehabilitation before head-and-neck chemoradiotherapy

Evidence label: Preliminary positive randomized signal · Clinical goal: preserve walking capacity and function before definitive chemoradiotherapy

Evidence at a glance

Population: 47 adults scheduled for definitive head-and-neck chemoradiotherapy; 40 were included in the primary analysis.
Intervention: supervised aerobic and resistance exercise three times weekly from enrollment until radiotherapy began.
Result: six-minute walk distance was 28.6 meters greater than with usual care at the end of the pretreatment period.

What was studied

FIT4TREAT was a prospective, single-center randomized trial. The primary endpoint was six-minute walk distance before treatment; strength, lower-limb function, body composition and quality of life were secondary outcomes.

What the evidence shows

The adjusted between-group difference in six-minute walk distance was 28.6 m (95% CI 4.1 to 53.1; P=.023). Lower-limb function improved and several quality-of-life measures were better preserved. The trial did not test tumor response, treatment completion or survival.

This is supportive-care or rehabilitation evidence. It does not show that the intervention treats cancer, prevents recurrence or prolongs survival unless a record explicitly identifies a validated cancer-control endpoint.

Limits and uncertainty

The study was small, seven enrolled participants were absent from the primary analysis, and the appraisal was limited to the PubMed abstract and registry. The duration depended on the interval before radiotherapy. Adverse-event details and a clinically meaningful walking-distance threshold were not reported in the abstract. Authors declared no competing interests.

Safety and practical context

Head-and-neck cancer can bring weight loss, anemia, airway symptoms and rapidly changing treatment schedules. Prehabilitation should be coordinated with oncology, nutrition and rehabilitation clinicians; it should not delay chemoradiotherapy.

Questions for the care team

Is there enough time before treatment to gain function without delaying therapy?
Do nutrition, anemia, airway or cardiac issues require an adapted program?
How will walking capacity and strength be monitored?

Sources

Literature searched: October 16, 2026 · Record appraised: October 16, 2026

Educational evidence summary, not personal medical advice. Research regimens describe what was studied; they are not personal prescribing instructions and should not replace cancer treatment or individualized supportive care.