{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:06:41Z","timestamp":1784549201883,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Interreg Deutschland\u2013Danmark program","award":["01-1-23 2"],"award-info":[{"award-number":["01-1-23 2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Radiation therapy with or without systemic treatment for lung cancer can cause adverse reactions, e.g., fatigue. Affected patients may experience a decrease in physical activity and, as a consequence, be unable to receive the complete assigned treatment. Physical exercise may be helpful. A benefit of exercise regarding completion of systemic treatment and quality of life was previously suggested. Irradiated patients may benefit as well. A smartphone-based app reminding patients to make a minimum number of steps might positively influence physical activity. The prototype of an app called \u201cStep Reminder\u201d was recently finalized. The randomized APPAREL trial (NCT07627022) evaluates whether this app can improve physical activity during irradiation for lung cancer. Methods: The primary endpoint of this phase 2 trial focuses on the within-patient change regarding the mean number of daily steps (week 5 minus week 1). Secondary objectives include satisfaction with the application and its impact on the perception of digital health technology. Patients are randomized 1:1 to be treated with a standard approach (conventionally fractionated irradiation with or without systemic treatment) supported by the \u201cStep Reminder\u201d app (Arm A) or standard treatment without the app (Arm B). The app provides reminders several times per day to walk a pre-defined number of steps. To make sure that the required 28 patients are included in the primary analysis population (full analysis set), 32 patients have to be randomized. Results: At this stage, results are not available. Conclusions: It is expected that the app will have a positive effect on the patients\u2019 physical activity (number of steps).<\/jats:p>","DOI":"10.3390\/jcm15145678","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:44:02Z","timestamp":1784544242000},"page":"5678","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protocol of a Randomized Trial Investigating the Value of a Reminder App to Increase Physical Activity During Radiotherapy or Radio-Chemotherapy for Locally Advanced Lung Cancer"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2046-4968","authenticated-orcid":false,"given":"Dirk","family":"Rades","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Luebeck, 23562 Luebeck, Germany"},{"name":"Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Karolin","family":"Streubel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesa","family":"Dziggel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansu","family":"Delikanli","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Luebeck Campus, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Bohnet","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University of Luebeck, 23562 Luebeck, Germany"},{"name":"Department of Pulmonology, University Medical Center Schleswig-Holstein, Luebeck Campus, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Luebeck, 23562 Luebeck, Germany"},{"name":"MVZ RON Niedersachsen Strahlentherapie GmbH, 30161 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darejan","family":"Lomidze","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Tbilisi State Medical University, 0177 Tbilisi, Georgia"},{"name":"Radiation Oncology Department, Ingorokva High Medical Technology University Clinic, 0177 Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Cacicedo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Cruces University Hospital, 48903 Barakaldo, Spain"},{"name":"Department of Radiation Oncology, Biobizkaia Health Research Institute, 48903 Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0559-4779","authenticated-orcid":false,"given":"Jasna","family":"But-Hadzic","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Department of Oncology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Falk Grauslund","sequence":"additional","affiliation":[{"name":"Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8073-5781","authenticated-orcid":false,"given":"Charlotte","family":"Kristiansen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Felix","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Christian-Albrechts University Kiel, 24105 Kiel, Germany"},{"name":"Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel Campus, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"ref_1","first-page":"e70043","article-title":"Cancer statistics, 2026","volume":"76","author":"Siegel","year":"2026","journal-title":"CA Cancer J. 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