The role of prehabilitation in improving brain health and cognition after chemotherapy in patients with colorectal cancer: Study protocol of the Chemo Brain Prehab Project.

The North West of England has a significantly higher incidence of colorectal cancer than the national average.

• Regional disparities in colorectal cancer incidence are a concern within the United Kingdom.
• The North West of England has a 37% higher incidence than the national average.
• This regional burden provides context for conducting the trial in this geographic area.

The trial will recruit eighty-six patients with stage II and III colorectal cancer receiving adjuvant and neoadjuvant chemotherapy.

• Eligible patients will receive fluorouracil, capecitabine, or oxaliplatin chemotherapy.
• Patients will be randomised between a prehabilitation group and a standard care group.
• The trial is registered at ClinicalTrials.gov under identifier NCT07341217.

The prehabilitation intervention involves a multimodal, home-based programme delivered before and during chemotherapy.

• The prehabilitation group will receive an individualised, home-based exercise programme.
• Additional components include multivitamin supplementation, telephone check-ins, and activity devices.
• The standard care group will receive information about physical activity and nutrition at the start of the intervention.
• Habitual physical activity will be tracked in all patients.

Assessments are scheduled at three time points relative to chemotherapy administration.

• Assessments will be conducted at baseline, 72 hours before the first chemotherapy administration, and 72–96 hours after the final treatment.
• Outcome measures will include cardiopulmonary fitness, neurotrophic biomarkers, electroencephalographic activity, cognitive function tests, and a cognitive-related quality of life assessment.

The study is designed to investigate whether prehabilitation can improve brain health and cognitive function in colorectal cancer patients undergoing chemotherapy.

• The trial addresses treatment-related cognitive impairment, described as a growing burden of chemotherapy side effects.
• Insights from this work 'may support the development of more accessible and effective prehabilitation programmes to address treatment specific cognitive impairment.'
• The home-based design is intended to improve accessibility of prehabilitation programmes.