Exercise: Participants will participate in up to twenty, supervised exercise sessions, performed within the radiotherapy department, immediately before each treatment. Each session has a 20 minute duration at one of four exercise intensity levels based on the participants baseline assessment results, and preferences.
radiotherapy: Study participants will have been diagnosed with stage I-III NSCLC and prescribed radiotherapy administered as 55Gy in 20 fractions over 4 weeks or 60Gy in 15 fractions over 3 weeks as their primary treatment as per standard treatment pathways within the trust
Study summary
The goal of this clinical trial is to understand the feasibility of a co-designed, pre-radiotherapy exercise programme for people with stage I-III non-small cell lung cancer. This involves people with lung cancer engaging in 20 minutes exercises sessions performed within the radiotherapy department and immediately before each treatment at a personalised intensity.
The main questions it aims to answer are:
To understand the acceptability of the exercise programme through monitoring recruitment rates, attendance of the exercise sessions, and adherence to prescribed exercise intensities. Adverse events will also be monitored to understand programme safety.
Follow-up qualitative interviews will be conducted with participants, their family members, and health care professionals (HCP) to further explore the acceptability of the exercise programme.
In total, participants will be invited to perform up to twenty, supervised exercise sessions scheduled immediately before each treatment within the radiotherapy department. Each exercise session will be twenty minutes in duration and will be performed on a stationary exercise bike. Regarding exercise intensity, there are four levels which may be prescribed depending on people's exercise history, baseline exercise experience, and personal preference. Participants may progress or regress exercise intensity levels throughout the programme depending on their adherence and preference.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Patients with clinically or histologically confirmed NSCLC stages 1-3.
* Planned to receive treatment with curative intention radiation as primary treatment.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
* At least 18 years of age.
* Can understand and communicate in English.
* Deemed safe to participate in moderate-intensity exercise and for ECG monitored maximal fitness test through the completion of a medical clearance form by their treating physician.
* Able to provide written and informed consent.
Exclusion Criteria:
* Unstable or new angina (diagnosed within the previous month).
* Unstable or acute heart failure, cardiomyopathy, or other uncontrolled cardiac disease (as evidenced by symptomatic fluid retention, excessive breathlessness, rapid weight gain, swollen ankles or pitting oedema) within the previous 3 months.
* Presence of new or uncontrolled cardiac arrhythmias.
* Confirmed or suspected spinal cord compression.
* Uncontrolled diabetes (e.g. medication changed within 1 month, has had episodes of hypoglycaemia during the previous 2 weeks, or hyperglycaemia which does not decrease with exercise during the previous 2 weeks).
* Is receiving combination treatment with chemotherapy or immunotherapy.
* Current active secondary malignancy other than non-melanoma skin cancer.
* Has had orthopaedic surgery within the previous 3 months on weight-bearing bones.
* Chest pain while undertaking exercise or physical activity.
* No \> Grade 2 peripheral neuropathy.
* Metastatic disease beyond localised metastatic involvement (e.g. bone or brain).
* Has discovered any abnormalities shown on the ECG monitored maximal fitness test which warrant early termination or contraindicate physical activity.
* People with living with a physical disability which would limit their ability to exercise safely on the stationary exercise bike used within this study.
* People who are non-English speakers.
* People who are pregnant.
* Patient participation in other clinical research - As an additional consideration, patients will be excluded if they are currently enrolled in an alternative exercise or physical activity study, as this may impact outcomes in both studies. However, if they have been involved in research prior to this or are currently involved in research in an unrelated area we will not immediately exclude them from trial participation. Instead, the Doctor of Philosophy (PhD) candidate, Chief investigator, and Principal investigator will discuss their involvement to determine safe and appropriate enrolment.
* Physical disability - it is with regret that we will be limited in our capacity to offer alternative exercises to accommodate people with a physical disability. To elaborate, the Belfast City Hospitals (BCH) main gym is willing to lend a stationary exercise bike to the research team in support of this study. However, due to limitations on equipment availability in the trust, and limited funding/resources to purchase equipment, people who have a physical disability which limits their capacity to exercise safely on the stationary bike will be excluded from this study. In an ideal scenario, we would also have a recumbent stationary bike to support more people with physical disability get involved within this research.
Primary outcome measure(s)
Eligibility rates — Screening and enrolment The percentage of eligible participants identified and approached through participant screening
Recruitment rate — Screening and recruitment The total number of potential participants who were approached and agreed to participate as a percentage of the total number who were approached
Exercise programme attendance — Weeks 4-8 (PReFACe exercise programme) The total number of attended sessions by the total number provided
Adherence to the exercise programme — Weeks 4-8 (PReFACe exercise programme) Monitoring the participants ability to complete the advised duration and intensity of exercise during each session (adherence is accepted if completed 75% of duration without intensity modification)
Participant retention rates — Week 0 (baseline assessment) to week 8 (PReFACe exercise programme end and post-intervention assessment) The number of participants available to provide outcomes at the post-intervention assessment as a percentage of the total number recruited.
Adverse event Common Terminology Criteria for Adverse Events (CTCAE) v5 — Week 0 (baseline assessment) to week 8 (PReFACe exercise programme end and post-intervention assessment) Assess the tolerability and safety of the intervention, via recording of intervention-associated adverse events (AE). AEs will be graded according to CTCAE v.5 as:
* Grade 1 = Mild
* Grade 2 = Moderate
* Grade 3 = Severe
* Grade 4 = Life-threatening consequences
* Grade 5 = Death related to AE
Trial sites (1)
Facility
City
Region
Status
Northern Ireland Cancer Centre, City Hospital, BHSCT
Belfast
Antrim
Recruiting
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This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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