Exercise before head and neck chemoradiotherapy preserved function

Design

Single-centre randomised controlled trial

Population

40 adults with head and neck cancer proposed for definitive chemoradiotherapy

Primary outcome

Six-minute walk distance at the end of the pre-treatment period

Effect

Adjusted between-group difference 28.6 m (95% CI 4.1 to 53.1), favouring prehabilitation

Patients with head and neck cancer often decline functionally even before chemoradiotherapy starts, and prehabilitation evidence in this non-surgical setting is thin. The FIT4TREAT single-centre randomised trial tested supervised exercise before treatment against usual care, analysing 40 of 47 enrolled patients.

The prehabilitation group did supervised aerobic and resistance exercise three times weekly from baseline until radiotherapy began. By the start of treatment they walked further on the six-minute walk test — an adjusted between-group difference of 28.6 m (95% CI 4.1 to 53.1) — with better lower-limb function and better-preserved quality-of-life, social-functioning and body-image scores.

This supports offering exercise prehabilitation in the window between diagnosis and chemoradiotherapy, which is often dead time otherwise. It is small and single-centre, so the effect size is uncertain, but the intervention is low-risk and the direction is consistent across measures.

• Single-centre randomised trial; 40 of 47 patients analysed, head and neck cancer before definitive chemoradiotherapy.
• Supervised aerobic and resistance exercise three times weekly until radiotherapy started.
• Six-minute walk distance was greater with prehabilitation (adjusted difference 28.6 m, 95% CI 4.1 to 53.1).
• Lower-limb function and quality-of-life, social-functioning and body-image scores were better preserved.
• Use the window between diagnosis and chemoradiotherapy for a low-risk exercise programme.

Why it matters

It turns the pre-treatment waiting period into a chance to protect function, in a group that otherwise declines before therapy even begins.

Don't overread it

A small single-centre trial of mostly functional and quality-of-life endpoints; it does not show an effect on cancer outcomes.

The statistics, in plain English

A 28.6 m gain on the six-minute walk is a modest but real improvement with the interval above zero; with only 40 patients at one centre, the true benefit could be smaller, though consistency across measures is reassuring.

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