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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.

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

Abstract

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.

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.

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.

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.

More about this publication

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Volume 33
Issue nr. 17
Pages 1918-27
Publication date 10-06-2015

Full text links

Publisher website (DOI) 10.1200/JCO.2014.59.1081
Europe PubMed Central 25918291
Pubmed 25918291

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