Multimodal prehabilitation to improve the clinical outcomes of frail elderly patients with gastric cancer: a study protocol for a multicentre randomised controlled trial (GISSG+2201)

预热 医学 社会心理的 模式治疗法 生活质量(医疗保健) 随机对照试验 物理疗法 临床试验 癌症 人口 内科学 护理部 精神科 环境卫生
作者
Yuqi Sun,Yulong Tian,Shougen Cao,Leping Li,Wenbin Yu,Yinlu Ding,Xixun Wang,Ying Kong,Xinjian Wang,Hao Wang,Xizeng Hui,Jianjun Qu,Hongbo Wang,Quanhong Duan,Daogui Yang,Huanhu Zhang,Shaofei Zhou,Xiaodong Liu,Zequn Li,Cheng Meng,Henrik Kehlet,Yanbing Zhou
出处
期刊:BMJ Open [BMJ]
卷期号:13 (10): e071714-e071714 被引量:4
标识
DOI:10.1136/bmjopen-2023-071714
摘要

Introduction Gastric cancer (GC) diagnosed in the elderly population has become a serious public health problem worldwide. Given the combined effects of frailty and the consequences of cancer treatment, older individuals with GC are more likely than young patients to suffer from postoperative complications and poor clinical outcomes. Nutrition, functional capacity and psychological state-based multimodal prehabilitation, which is dominated by Enhanced Recovery After Surgery (ERAS) pathway management, has been shown to reduce postoperative complications, promote functional recovery and decrease hospitalisation time in certain malignancies. However, no previous studies have investigated the clinical application of multimodal prehabilitation in frail older patients with GC. Methods and analysis The study is a prospective, multicentre randomised controlled trial in which a total of 368 participants who meet the inclusion criteria will be randomised into either a prehabilitation group or an ERAS group. The prehabilitation group will receive multimodal prehabilitation combined with ERAS at least 2 weeks before the gastrectomy is performed, including physical and respiratory training, nutritional support, and therapy and psychosocial treatment. The ERAS group patients will be treated according to the ERAS pathway. All interventions will be supervised by family members. The primary outcome measures are the incidence and severity of postoperative complications. Secondary outcomes include survival, functional capacity and other short-term postoperative outcomes. Overall, the multimodal prehabilitation protocol may improve functional capacity, reduce the surgical stress response and concomitant systemic inflammation, and potentially modulate the tumour microenvironment to improve short-term and long-term clinical outcomes and patients’ quality of life. Ethics and dissemination All procedures and participating centres of this study were approved by their respective ethics committees (QYFYKYLL 916111920). The final study results will be published separately in peer-reviewed journals. Trial registration number NCT05352802 .
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