We know that exercise is safe for patients with non-metastatic cancer and that it has a positive effect on the disease and treatment related side effects. Exercise has been shown to have a positive effect in people treated for non-metastatic esophageal cancer. They are less tired, are fitter and experience a better quality of life. However, we know little about what exercise in combination with nutrition can mean for patients with metastatic esophageal or gastric cancer. It is possible that exercise in combination with nutrition in these patients also improves their quality of life, but we do not know that currently.

The aim of the RADICES study is to investigate the effects of a 12-week exercise and nutrition intervention for patients with metastatic esophageal or gastric cancer. The intervention will be completely tailored to the condition and nutritional status of the patient. We will look at what this combined intervention does to quality of life and other aspects related to the disease and the treatment of the patients. The RADICES study is a multicenter randomized controlled trial, funded by KWF. Currently, 8 different hospitals across the Netherlands are including patients and more hospitals will follow. Participants randomized to the intervention group, will visit an oncology physiotherapist twice a week and will work on cardiorespiratory fitness and strength according to our protocol. They will receive biweekly advice from a dietician in the hospital, focusing on increased energy and protein intake. Patients in the control group, proceed with their usual care. All participants fill out questionnaires on quality of life, nutritional intake and receive a Fitbit for insight in their daily activity.

Inclusion has started in January 2024 and evaluation of the first months shows that the protocol is tolerated well by participants and the study intervention is feasible for both physiotherapists and dieticians in daily practice. The coming years we proceed to include more patients and get more insight in our primary endpoint: quality of life. The RADICES study team consists of the following people:

Prof. dr. Hanneke van Laarhoven (AUMC), prof. dr. Anne May, dr. ir. Nicolette Wierdsma (AUMC), dr. Anouk Hiensch andn Aniek Bonhof, MD (PhD candidate).

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