Effectiveness of multimodal medical rehabilitation program in a patient with esophageal cancer, severe metabolic disturbances, and functional deficiency: A case report
Olga A. Obukhova , Ildar A. Kurmukov , Grigory S. Yunaev , Natalya Yu. Shagina
Clinical nutrition and metabolism ›› 2024, Vol. 5 ›› Issue (4) : 187 -194.
Effectiveness of multimodal medical rehabilitation program in a patient with esophageal cancer, severe metabolic disturbances, and functional deficiency: A case report
BACKGROUND: Following neoadjuvant chemotherapy (NACT), patients with esophageal cancer may develop severe functional impairments that render radical surgical intervention impossible. We present a clinical case of severe functional deficiency that developed in a patient with esophageal cancer during NACT, necessitating comprehensive medical rehabilitation prior to radical surgical intervention.
Case description: A 75-year-old male was diagnosed with adenocarcinoma of the distal esophagus, stage cT3N0M0 (stage II). He received four cycles of antitumor therapy using the FLOT regimen (fluorouracil, calcium folinate, oxaliplatin, docetaxel), with a positive response. Radical surgical treatment was indicated; however, severe functional decline combined with metabolic disturbances precluded the procedure. A multimodal medical rehabilitation program, including therapeutic exercise, limb massage, nutritional support, and correction of metabolic and fluid-electrolyte imbalances, enabled clinical stabilization of patient within a short period.
CONCLUSION: Given the multifaceted nature of functional impairments in patients with esophageal cancer, medical rehabilitation should be based on multimodal programs incorporating symptomatic drug therapy. This approach appears to be optimal in this patient cohort.
chemotherapy / esophageal cancer / indirect calorimetry / nutritional support / rehabilitation / case report
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