Nitin Ohri, MD

Reducing Toxicity with a Simple Walking Program

Nitin Ohri, MD, and his team at the Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine conducted a randomized clinical trial to determine if giving cancer patients daily customized step count goals as measured and guided through fitness trackers could improve their ability to tolerate concurrent chemoradiotherapy. Results from their pilot study suggested that step counts may serve as dynamic predictors of short-term hospitalization risk during chemoradiotherapy, and with his Innovative Projects in Radiation Oncology award, Dr. Ohri explored whether physical activity could also be used as a treatment.

In the clinical trial, Dr. Ohri and his team:

• Collected activity data by providing patients with a Garmin Vivofit® activity tracker to wear throughout their standard course of chemotherapy and radiotherapy.
• Gave patients in the experimental arm of the study customized daily step count goals, which were based on the previous day’s performance and displayed on their activity trackers.
• Examined whether the walking program increased step counts, lessened treatment-related toxicities, improved quality of life, decreased systemic inflammation and reduced the frequency of treatment interruptions.

The results to date are promising, and implementing a similar program could be an easy and relatively low cost supportive care measure that almost any clinician could incorporate into his or her practice to help improve outcomes for their patients.

Publications

• Predictors of Financial Toxicity in Patients Receiving Concurrent Radiation Therapy and Chemotherapy was published online December 10, 2022 in Advances in Radiation Oncology. 
• Cardiac Irradiation Predicts Activity Decline in Patients Receiving Concurrent Chemoradiation for Locally Advanced Lung Cancer was published online June 1, 2020, in the International Journal of Radiation Oncology • Biology • Physics.   
• Daily Step Counts: A New Prognostic Factor in Locally Advanced Non-Small Cell Lung Cancer? was an Issue Highlight in the November 15, 2019 International Journal of Radiation Oncology • Biology • Physics.   

Presentations 

• Machine Learning-Based Prediction of Hospitalization Using Daily Step Counts for Patients Undergoing Chemoradiation was presented at the 2022 ASTRO Annual Meeting.
• Daily Step Counts to Predict Hospitalizations During Chemoradiotherapy for Head and Neck Cancer was presented at the 2021 ASCO Annual Meeting. 
• Daily Step Counts to Predict Hospitalizations During Concurrent Chemoradiotherapy for Solid Tumors was presented at the 2019 ASCO Quality Care Symposium.
• Daily Step Counts Predict Outcomes for Locally Advanced Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy was presented at the 2019 ASTRO Annual Meeting. 
• Cardiac Dosing Predicts Activity Decline During Concurrent Chemoradiation for Locally Advanced Lung Cancer was presented at the 2018 ASTRO Annual Meeting.