title: [Effects of strength- and endurance oriented training during regional chemotherapy in metastatic rectal carcinoma. Case report as a contribution to surgical oncology].
abstract: OBJECTIVE
  How does adjuvant training of strength and endurance influence the muscular, cardial, respiratory, immunological systems, and the quality of life during intrahepatical chemotherapy in a veteran athlete with liver metastasis after resection of a carcinoma of the rectum.
  
  
  METHODS
  A 58-year-old athlete with metastatic carcinoma of the rectum (pT3, N0, M-liver, G2) underwent regional chemotherapy (folinic acid, 5-fluorouracil) via an intrahepatic port system. Six cycles with 5 days each were applied. During the intervals between cycles (14 days), beginning in the 6th postoperative week, a strength and endurance training (duration 13 weeks) was carried out twice weekly with an intensity of 40-60% of the maximum postoperative individual power and endurance (evaluated with weight and treadmill exercise tests and measurement of lactate). Before and after chemotherapy, an echocardiogram, resting and exercise electrocardiogram, lung function, natural killer cells and the gastrointestinal quality of life index (GLQI) was evaluated. After chemotherapy was finished, the effects of training were assumed.
  
  
  RESULTS
  Strength increased between 0% and 144%. Endurance improvement was measured on the last comparable submaximal intensity step, expressed by reduction of heart rate and lactate concentration by 10 and 21.5%, respectively, improvement of lung function regarding FEV 1 and FCV by 12.9 and 11.3%, respectively, and VC IN 11.4%. The relative count of natural killer cells increased by 27.2%, and the GLQI improved from 109 points (pathologic) to 129 points (normal).
  
  
  CONCLUSIONS
  There were positive effects on muscular and cardial mechanisms of adaptation and on illness-related quality of life. Postoperative sports activity during regional chemotherapy is possible.
authors.affiliation: Orthopädische Universitätsklinik, Homburg/Saar. jens.Kelm@med-rz.uni-sb.de
authors.forename: J
authors.initials: J
authors.lastname: Kelm
authors.forename: P
authors.initials: P
authors.lastname: Schliesing
authors.forename: P
authors.initials: P
authors.lastname: Weissenbach
authors.forename: G
authors.initials: G
authors.lastname: Deubel
authors.forename: T
authors.initials: T
authors.lastname: Regitz
authors.forename: C
authors.initials: C
authors.lastname: Engel
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D015444:Exercise / Q000502:physiology; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D014891:Weight Lifting / Q000502:physiology