MS-N172 · Exercise and rehabilitation · nonmetastatic abdominal cancers receiving concurrent chemoradiotherapy
Evidence at a glance
- Question: Can an app-supported multidisciplinary program preserve strength and muscle during abdominal-cancer chemoradiotherapy?
- Finding: A phase II trial found better handgrip strength and several secondary nutritional and muscle outcomes, but the bundled program prevents attributing the effect to exercise alone.
- Evidence label: Preliminary positive randomized multimodal evidence
- Benefit: Adjusted handgrip strength was 4.87 kg higher at treatment completion.
- Certainty: Low-to-moderate for the bundled program; low for any single component.
- Risk: Short-term supervised program in selected ECOG 0–1 patients; broader safety and durability remain uncertain.
- Cancer-control boundary: Strength, nutrition and toxicity outcomes do not establish tumor response, recurrence reduction or survival.
What was studied
Three Chinese cancer centers enrolled adults with nonmetastatic abdominal malignancies receiving five to six weeks of neoadjuvant or adjuvant concurrent chemoradiotherapy.
- Design and comparator: Prospective, multicenter, open-label randomized phase II trial; multidisciplinary mobile rehabilitation plus standard care versus standard care.
- Participants: 111 randomized: 57 intervention and 54 control.
- Intervention: App- and wearable-supported exercise, individualized nutrition, psychological support and weekly multidisciplinary review throughout chemoradiotherapy.
- Primary outcome and follow-up: Handgrip strength at the end of chemoradiotherapy, adjusted for baseline. Four-week post-treatment assessments were also collected.
What the study found
Adjusted handgrip strength favored rehabilitation by 4.87 kg (95% CI 3.36–6.38; P<.001). Prespecified/exploratory secondary measures—including skeletal muscle, body weight, albumin, prealbumin and selected toxicity and distress measures—also favored intervention and remained nominally significant after false-discovery-rate correction.
Negative or uncertain findings: Because exercise, nutrition, psychology, monitoring and early clinical response were bundled, no component-specific effect can be inferred. Tumor control and long-term survival were not established.
Limits and applicability
Open-label, short follow-up, heterogeneous tumor sites and fit smartphone-using participants limit generalizability. Phase II results require phase III confirmation.
Funding and conflicts: Investigator-initiated. The app was supplied by Beijing AiNST Medical Technology; one author was affiliated with the company, which the article states had no role in design, analysis, interpretation or writing.
Safety context
People with obstruction, uncontrolled cardiovascular disease, organ dysfunction or inability to exercise were excluded. During chemoradiotherapy, dehydration, diarrhea, weight loss, cytopenias and infection can require rapid program modification.
Questions for the care team
- Which parts of the program—exercise, nutrition, psychology or monitoring—are locally available?
- How will weight, intake, strength and treatment toxicity be followed?
- What symptoms or laboratory values should pause activity?
Primary sources
Last literature search: 29 October 2026. Record appraisal: 29 October 2026. This page is educational and does not replace individualized medical advice. Exercise prescriptions should be adapted to diagnosis, treatment, surgical restrictions, blood counts, cardiopulmonary status, neuropathy, fall risk and bone-metastasis location. Symptom or fitness improvement is not proof of tumor response, recurrence prevention or longer survival unless those outcomes were directly tested.
