Long-Term Changes in Physical Activity Among Cancer Survivors After Concurrent Chemoradiotherapy: A Prospective Study.

Zakharia, Adel; Kabarriti, Rafi; Bodner, William R; Mehta, Keyur J; Halmos, Balazs; Kalnicki, Shalom; Garg, Madhur; Ohri, Nitin · Int J Radiat Oncol Biol Phys · 2026

prospective_cohort · Level II

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Abstract

Wearable activity monitors provide objective assessment of physical activity, yet long-term data following curative-intent chemoradiotherapy remain limited. We enrolled 17 cancer survivors a mean of 5.4 years (range, 4.2-7.3) after chemoradiotherapy and compared wearable-derived step count averages at baseline and long-term follow-up. Fourteen participants (82%) had lower step counts at follow-up compared with baseline, with a median relative decline of -43% (IQR, -65% to -23%), corresponding to a median annualized rate of -12% per year. No patient- or disease-related characteristics were significantly associated with activity change in the full cohort. In the lung cancer subset (n=9), higher mean heart radiotherapy dose was associated with greater activity decline (coefficient -2.7 per Gy; p=0.034). Physical activity remains substantially reduced among long-term cancer survivors following curative-intent chemoradiotherapy, and conventional clinical factors showed limited ability to predict this decline.