Evaluation of physical rehabilitation in patients receiving curative treatment for head and neck cancer: The NUTRIMOUV randomized phase II trial.

PURPOSE: Patients with head and neck squamous cell carcinoma (HNSCC) undergoing curative radiotherapy or chemoradiotherapy often experience adverse effects affecting physical and psychosocial health, which can lead to a deconditioning cycle, worsening side effects, treatment tolerance and quality of life. This multicenter phase II study evaluated whether physical rehabilitation combined with nutritional care could improve exercise tolerance and reverse the deconditioning cycle.

METHODS

Patients with localized HNSCC undergoing curative radiotherapy or chemoradiotherapy were randomized into two groups. One group engaged in a physical rehabilitation (PR) program, including quadriceps electrical stimulation three times a week during treatment, followed by three weekly sessions of home-based ergocycle training for 12 weeks, while the control (CT) group received standard care. Both groups received nutritional care. Success of the PR program was defined as a 40% increase in the patient's baseline endurance time or the ability of the patient to sustain the activity for 30 min at three months.

RESULTS

Seventy patients were included, with 33 patients in the PR group. The success rate was higher in the PR group program (68%, CI 95% 48-84) than to the CT group (27%, CI 95% 16-48). From T0 to T2, the median endurance time changed by + 54% in PR vs. -55% in CT. No significant difference was observed regarding quality of life.

CONCLUSIONS

Our results highlight that physical rehabilitation combined with nutritional care is feasible in this setting, and could improve exercise tolerance without modifying patient's quality of life. It emphasizes the crucial role of physical activity during cancer treatment.

CLINICAL TRIAL REGISTRATION NUMBER: NCT02135185 on February 6, 2014 (retrospectively registered).