The implementation status of prehabilitation during neoadjuvant chemotherapy for patients with locally advanced esophageal cancer: a questionnaire survey to the board-certified facilities in Japan

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发表日期：

2024年7月24日

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Tsuyoshi Harada,
Tetsuya Tsuji,
Takuya Fukushima,
Tomohiro Ikeda,
Shusuke Toyama,
Nobuko Konishi,
Hiroki Nakajima,
Katsuyoshi Suzuki,
Keiji Matsumori,
Takumi Yanagisawa,
Kakeru Hashimoto,
Hitoshi Kagaya,
Sadamoto Zenda,
Takashi Kojima,
Takeo Fujita,
Junya Ueno,
Nanako Hijikata,
Aiko Ishikawa,
Ryuichi Hayashi

摘要

Background

Prehabilitation during neoadjuvant therapy has the potential to improve clinical outcomes. However, information on its global dissemination status is limited. This Japanese nationwide survey investigated the implementation status of and barriers to prehabilitation during neoadjuvant chemotherapy (NAC) for patients with locally advanced esophageal cancer in hospitals.

Methods

This multicenter nationwide survey was conducted by post. The eligible facilities were 155 Japanese hospitals that had been certified within the last 10 years as authorized institutes for board-certified esophageal surgeons by the Japan Esophageal Society. We administered an original questionnaire to investigate the current status of prehabilitation during NAC.

Results

The response rate was 75% (117/155 facilities). Forty-six facilities (39%) provided prehabilitation during NAC. The most frequently selected reasons for not providing or providing insufficient prehabilitation were lack of human resources, issues with the reimbursement of medical fees, difficulty in providing continuous prehabilitation during repeated inpatient and outpatient care, the lack of established standard prehabilitation programs, challenges in providing multidisciplinary prehabilitation, and difficulty in managing physical symptoms.

Conclusion

We observed that the implementation rate of prehabilitation during NAC was low. Critical reasons were not only the lack of medical resources but also the lack of evidence-based standard prehabilitation programs during NAC and the lack of evidence for how to continuously deliver prehabilitation during NAC to patients with physical symptoms.