Cardiac Rehabilitation for Patients Receiving Radiation Therapy for Thoracic Cancers

The Washington University

Status: Terminated

Conditions: Breast Cancer; Thymoma; Hodgkin Lymphoma; Sarcoma; Non-hodgkin Lymphoma; Esophageal Cancer; Hodgkin Disease; Lung Cancer; Thoracic Cancer

Treatments: Procedure: Home-based cardiac rehabilitation

Study type: Interventional

Funder types: Other

Identifiers

NCT04072393

201909133

Details and patient eligibility

About

Other than optimizing medical management of cardiac risk factors, and reducing radiotherapy (RT) dose to the heart, there currently exist no interventions to mitigate or reverse the adverse cardiac effects of RT. Aerobic exercise has been demonstrated to improve patient quality of life, cardiac outcomes, and cardiorespiratory fitness in patients with cancer receiving cardiotoxic systemic therapies, but the effects of aerobic exercise on patients at high risk for radiation induced heart disease (RIHD) is unknown. In addition, home-based cardiac rehabilitation has not been tested in patients with thoracic cancers.

Enrollment: 24 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Pathologically confirmed or radiographically diagnosed non-small cell lung cancer, small cell lung cancer, esophageal cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, sarcoma, thymoma, or left-sided breast cancer.
• Planning to receive neo-adjuvant, adjuvant, or definitive radiation therapy to the thorax with curative intent.
• Willing to participate in home-based cardiac rehabilitation program and be monitored remotely via smart phone application
• Possess a smart phone or tablet capable of supporting teleHeart application
• Willing and eligible to co-enroll in the Cardiovascular Toxicity in Cancer and Improvement in Recovery (SURVIVE) Registry Study (HRPO# 201801031).
• At least 18 years of age.
• ECOG performance status ≤ 2
• Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).

Exclusion criteria

• Presence of distant metastatic disease (except patients with lymphoma).
• Life expectancy less than 6 months
• Patient lives in skilled nursing facility, chronic care facility, nursing home, or palliative care or hospice facility
• Unable to walk
• Presence of significant cancer disease burden that would make patient unlikely to tolerate cardiac rehabilitation (CR)
• Diagnosis of primary cervical esophageal cancer.
• Presence of unstable angina.
• Recipient of heart transplant.
• Patient on cardiac transplant list or has a ventricular assist device
• Patient's baseline weight > 300 lbs (due to weight limitations of the scale and bioelectrical impedance device)
• Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.
• Other medical comorbidities that make the patient unable to participate in the CR program or other assessments involved with this study.

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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24 participants in 1 patient group

Home-based cardiac rehabilitation

Experimental group

Description:

* The intervention consists of a prescribed course of home-based cardiac rehabilitation: 36 sessions, three times a week, one hour each, over a period of 12 weeks. * Each customized exercise session includes three phases: * a 5- to 10-minute warm-up which consists of stretching, flexibility movements, and aerobic activity which gradually raises the heart rate to the desired level * a conditioning or training phase, which consists of 20 to 45 minutes of continuous or discontinuous aerobic activity * a cool down for 5 to 10 minutes consisting of low-intensity exercise that permits a gradual recovery from the conditioning phase * The patient will complete a brief questionnaire on the teleHeart application after completing each exercise session on how well they tolerated the exercise. The patient's CR team will receive daily updates from the patient's teleHeart application. Based on feedback from the application, the CR team may modify the patient's exercise program going forward.

Treatment:

Procedure: Home-based cardiac rehabilitation