Kerry S. Courneya
Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial
Courneya, Kerry S.; McKenzie, Donald C.; Mackey, John R.; Gelmon, Karen; Friedenreich, Christine M.; Yasui, Yutaka; Reid, Robert D.; Cook, Diane; Jespersen, Diana; Proulx, Carolyn; Dolan, Lianne B.; Forbes, Cynthia C.; Wooding, Evyanne; Trinh, Linda; Segal, Roanne J.
Donald C. McKenzie
John R. Mackey
Christine M. Friedenreich
Robert D. Reid
Lianne B. Dolan
Dr Cynthia Forbes C.Forbes@hull.ac.uk
Career Development Research Fellow
Roanne J. Segal
Exercise improves physical functioning and symptom management during breast cancer chemotherapy, but the effects of different doses and types of exercise are unknown.
A multicenter trial in Canada randomized 301 breast cancer patients to thrice-weekly supervised exercise during chemotherapy consisting of either a standard dose of 25 to 30 minutes of aerobic exercise (STAN; n = 96), a higher dose of 50 to 60 minutes of aerobic exercise (HIGH; n = 101), or a combined dose of 50 to 60 minutes of aerobic and resistance exercise (COMB; n = 104). The primary endpoint was physical functioning assessed by the Medical Outcomes Survey-Short Form (SF)–36. Secondary endpoints were other physical functioning scales, symptoms, fitness, and chemotherapy completion. All statistical tests were linear mixed model analyses, and the P values were two-sided.
Follow-up assessment of patient-reported outcomes was 99.0%. Adjusted linear mixed-model analyses showed that neither HIGH (+0.8; 95% confidence interval [CI] = −0.8 to 2.4; P = .30) nor COMB (+0.5; 95% CI = −1.1 to 2.1; P = .52] were superior to STAN for the primary outcome. In secondary analyses not adjusted for multiple comparisons, HIGH was superior to STAN for the SF-36 physical component summary (P = .04), SF-36 bodily pain (P = .02), and endocrine symptoms (P = .02). COMB was superior to STAN for endocrine symptoms (P = .009) and superior to STAN (P < .001) and HIGH (P < .001) for muscular strength. HIGH was superior to COMB for the SF-36 bodily pain (P = .04) and aerobic fitness (P = .03). No differences emerged for body composition or chemotherapy completion.
A higher volume of aerobic or combined exercise is achievable and safe during breast cancer chemotherapy and may manage declines in physical functioning and worsening symptoms better than standard volumes.
|Journal Article Type||Article|
|Publication Date||Dec 4, 2013|
|Journal||JNCI: Journal of the National Cancer Institute|
|Publisher||Oxford University Press (OUP)|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Courneya, K. S., McKenzie, D. C., Mackey, J. R., Gelmon, K., Friedenreich, C. M., Yasui, Y., …Segal, R. J. (2013). Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial. JNCI: Journal of the National Cancer Institute, 105(23), 1821-1832. doi:10.1093/jnci/djt297|
|Keywords||Aerobic exercise; Chemotherapy regimen; Exercise; Canada; Pain; Palliative care; Breast cancer; Exercise; Resistive; Surrogate endpoints; sf-36; Patient self-report; Physical function|