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Abstract
Introduction. Renal cell carcinoma (RCC) remains a significant oncological challenge. Immunotherapy represents a modern treatment approach; however, patients often experience side effects that impair quality of life. Physical rehabilitation, as a comprehensive method, may improve well-being and potentially enhance therapeutic efficacy, but data on its application in RCC patients receiving immunotherapy remain limited.
Aim. To evaluate the effects of a comprehensive physical rehabilitation program on the clinical status of RCC patients undergoing immunotherapy.
Materials and Methods. The study included 102 RCC patients, divided into an intervention group (n = 52) receiving immunotherapy (nivolumab or pembrolizumab) plus comprehensive physical rehabilitation (therapeutic exercise and breathing exercises), and a control group (n = 50) without rehabilitation. Patient follow-up averaged 6 months. Tumor response was assessed using iRECIST criteria, adverse events were graded according to CTCAE v5.0. Clinical manifestations were recorded before and after treatment.
Results. The clear-cell variant predominated (approximately 83%), with most patients showing moderate differentiation (72.6%). The intervention group demonstrated high rates of disease stabilization (57.7%) and partial response (13.5%). Following rehabilitation, significant reductions were observed in symptoms including back and lumbar pain (from 40.0% to 16.7%), dyspnea (from 36.7% to 13.3%), and depression (from 26.7% to 6.7%) compared to controls (p < 0.05). The control group showed minimal changes or worsening of these symptoms.
Conclusion. Comprehensive physical rehabilitation in RCC patients undergoing immunotherapy improves clinical status and reduces quality-of-life-impairing symptoms. These findings support the integration of therapeutic exercise into standard treatment protocols for RCC patients to enhance therapeutic efficacy and improve outcomes.
References
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