Multimodal rehabilitation to improve quality of life and fatigue after radiotherapy in esophageal cancer patients: a randomized trial

Abstract Purpose To compare the effects of nurse-led multimodal rehabilitation with conventional rehabilitation on quality of life and physical recovery during adjuvant radiotherapy for postoperative esophageal cancer. Methods Seventy participants were randomized into a control group (N = 35) receiving conventional care and a multimodal group (N = 35) receiving nurse-led multimodal rehabilitation. Outcomes including quality of life, dyspnea index, fatigue, sleep quality, nutrition, anxiety, and depression status were recorded before the start of radiotherapy (T0), after completion of radiotherapy (T1), and 6 months (T2) and 12 months (T3) after completion of radiotherapy. Data were analyzed using intention-to-treat principles and linear mixed models. Results The multimodal group significantly increased the global health scores compared to the control group at T1 (p < 0.001), with differences remaining significant at T2 (p = 0.002) and T3 (p = 0.005). The weight of the multimodal group was also significantly higher than that of the control group at T1 (p = 0.008), with the difference remaining significant at T2 (p = 0.033) and T3 (p = 0.020). The fatigue score of the multimodal group decreased significantly at T1 (p < 0.001) and remained significant at T2 (p < 0.001) and T3 (p = 0.005). The anxiety and depression status of the multimodal group improved significantly at T1, and the difference remained significant at T2 (all p < 0.05). Conclusion Nurse-led multimodal rehabilitation significantly improved quality of life, sleep quality, nutrition, fatigue, anxiety, and depression status in patients undergoing postoperative radiotherapy for esophageal cancer.