Feasibility of a 12-month-exercise intervention during and after radiation and chemotherapy in cancer patients: Impact on quality of life, peak oxygen consumption, and body composition

Abstract

Background: Accumulating evidence suggests that exercise is effective in treating many of the acute and chronic side effects of anti-cancer therapy. A recent meta-analysis supported the use of exercise to prevent or treat fatigue and lymphoedema and to improve functional status in breast cancer patients. Patients and methods: This trial was intended as a controlled, prospective feasibility study evaluating the impact of physical exercise (PE) in cancer patients during and after treatment with radio- and chemotherapy. Inclusion criteria were previous or ongoing treatment for cancer, motivation for PE of 0.5-1 hour duration at least twice weekly for at least 3months. Continuation of PE was encouraged thereafter. Every three months the following endpoints were assessed: Peak oxygen consumption as measured by supervised cardiopulmonary exercise test, body composition and quality of life. Results: A total of 45 patients were included with a median age of 49 years. Forty were female and five male. Cancer types were: Breast cancer (n = 30/67%), gastrointestinal cancer (n = 5/12%), other types (n = 10/22%). Thirty-eight (84%) of the patients were included during curative treatment of their disease. Seven (16%) were considered palliative. Adherence to the PE-programme longer than 6 months was noted for 41/45 (91%) of the patients. Intensity of PE was thrice weekly in 32/45 (71%), twice weekly in 11/45 (24%). Two of 45 patients (5%) had no PE. Mean peak oxygen consumption increased from 18.8 ± 5.6 ml/min/kg to 20.5 ± 3 ml/min/kg and 19.9 ± 4.7ml/min/kg at 3months (p = 0.005) and 12 months (p = 0.003), respectively. Median fat mass decreased from 30.7 ± 15 kg to 28.9 ± 15 kg and 29.5 ± 13 kg at 3 months (p = 0.001) and 12months (p = 0.017), respectively. Global health status scores increased from a median baseline value of 54.9 ± 16.3 to 66.4 ± 14% and 68.0 ± 20.3% at 3 months (p = 0.001) and 12 months (p = 0.002), respectively. Conclusion: This exercise programme in cancer patients with 2-3 weekly supervised sessions over three months was well feasible and demonstrated measurable improvement of oxygen consumption, body composition and quality of life. In addition, a 90%-adherence rate to the PE-programme beyond 6months was encouraging. Further randomized prospective data in a larger patient population will be collected comparing the impact of two versus four months supervision.