Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial.

Abstract

PURPOSE:

We evaluated the effectiveness of a low-intensity, home-based physical activity program (Onco-Move) and a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack) versus usual care (UC) in maintaining or enhancing physical fitness, minimizing fatigue, enhancing health-related quality of life, and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer.

PATIENTS AND METHODS:

We randomly assigned patients who were scheduled to undergo adjuvant chemotherapy (N = 230) to Onco-Move, OnTrack, or UC. Performance-based and self-reported outcomes were assessed before random assignment, at the end of chemotherapy, and at the 6-month follow-up. We used generalized estimating equations to compare the groups over time.

RESULTS:

Onco-Move and OnTrack resulted in less decline in cardiorespiratory fitness (P < .001), better physical functioning (P ≤ .001), less nausea and vomiting (P = .029 and .031, respectively) and less pain (P = .003 and .011, respectively) compared with UC. OnTrack also resulted in better outcomes for muscle strength (P = .002) and physical fatigue (P < .001). At the 6-month follow-up, most outcomes returned to baseline levels for all three groups. A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups (P = .002). Both intervention groups returned earlier (P = .012), as well as for more hours per week (P = .014), to work than the control group.

CONCLUSION:

A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program.

• Authors: Hanna van Waart, Martijn M Stuiver, Wim H van Harten, Edwin Geleijn, Jacobien M Kieffer, Laurien M Buffart, Marianne de Maaker-Berkhof, Epie Boven, Jolanda Schrama, Maud M Geenen, Jetske M Meerum Terwogt, Aart van Bochove, Vera Lustig, Simone M van den Heiligenberg, Carolien H Smorenburg, Jeannette A J H Hellendoorn-van Vreeswijk, Gabe S Sonke, Neil K Aaronson
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 33 Issue 17 Pg. 1918-27 (Jun 10 2015) ISSN: 1527-7755 [Electronic] United States
• PMID: 25918291 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 by American Society of Clinical Oncology.

Chemical References

• Antibodies, Monoclonal, Humanized
• Trastuzumab

Topics

• Activities of Daily Living
• Adult
• Aged
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Breast Neoplasms (drug therapy)
• Chemotherapy, Adjuvant
• Drug Administration Schedule
• Exercise
• Exercise Therapy
• Fatigue (prevention & control)
• Female
• Follow-Up Studies
• Health Status
• Humans
• Middle Aged
• Motor Activity
• Muscle Strength
• Nausea (chemically induced, prevention & control)
• Pain (etiology, prevention & control)
• Physical Fitness
• Quality of Life
• Self Report
• Trastuzumab
• Treatment Outcome
• Vomiting (chemically induced, prevention & control)