Radiation Oncology/Supportive care/Exercise

Exercise and Raditation Therapy Breast cancer Rochester -- exercise x4 weeks vs. control Randomized. 38 breast or prostate cancer patients. Arm 1) Home-based aerobic and progressive resistance exercise x4 weeks at start of RT vs. Arm 2) control. 2009 PMID 19831159 -- "A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial." (Mustian KM, J Support Oncol. 2009 Sep-Oct;7(5):158-67.) Outcome: Good adherence to intervention. At 3 months, significantly more daily steps walked, daily minutes of resistance exercise, number of resistance exercise days. Also significantly higher QoL and significantly lower cancer-related fatigue Conclusion: Exercise during RT may be beneficial for cancer patients Bangalore, India -- brief supportive therapy vs. yoga Randomized. 38 patients, Stage II-III breast cancer, who received surgery, adjuvant RT and adjuvant chemotherapy. Arm 1) routine supportive therapy vs. Arm 2) yoga 60 min daily. Evaluated at baseline, after surgery, before/during/after RT and chemotherapy 2009 PMID 19114222 -- "Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial." (Rao MR, Complement Ther Med. 2009 Jan;17(1):1-8. Epub 2008 Oct 14.) Outcome: yoga group decreased self-reported anxiety and trait anxiety (SS), positively correlated with symptom severity during RT Conclusion: Yoga can be used for managing treatment-related symptoms and anxiety in BCA patients Sungkyunkwan, Seoul -- moderate intensity exercise vs. observation Randomized. 40 women after adjuvant RT for breast cancer. Arm 1) supervised moderate-intensity exercise (50 min 3x/week x5 weeks, including stretching, shoulder exercises, and aerobic exercise) vs. Arm 2) observation 2008 PMID 18581595 -- "Effects of supervised exercise therapy in patients receiving radiotherapy for breast cancer." (Hwang JH, Yonsei Med J. 2008 Jun 30;49(3):443-50.) Outcome: Exercise group increased QoL, shoulder ROM, decreased fatigue, decreased fatigue. Control group worse than baseline in QoL, shoulder ROM, fatigue, pain Conclusion: Patients receiving RT for breast CA may benefit from supervised moderate-intensity exercise Alberta (2003-2005) -- usual care vs. resistance exercise vs. aerobic exercise Randomized. 242 patients undergoing adjuvant chemo. Arm 1) usual care, vs. Arm 2) supervised resistance exercise vs. Arm 3) supervised aerobic exercise. Adherence 70% 2007 PMID 17785708 -- "Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial." (Courneya KS, J Clin Oncol. 2007 Oct 1;25(28):4396-404.) Outcome: Aerobic exercise significantly superior for self-esteem, fitness, and % body fat. Resistance exercise significantly superior for self-esteem, strength, lean body mass, and chemo completion rate. No difference in cancer-specific QoL Conclusion: No difference in either regimen on cancer-specific QoL, but improvement in self-esteem, physical fitness, and body composition Albert Einstein; 2007 -- yoga vs. observation Randomized. 128 patients (42% black, 31% hispanic), ~50% on treatment. Arm 1) 12-week yoga vs. Arm 2) control 2007 PMID 17785709 -- "Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life." (Moadel AB, J Clin Oncol. 2007 Oct 1;25(28):4387-95.) Outcome: yoga group better social well-being (SS). However, limited adherance, worse with increased fatigue, RT, younger age, and no anti-estrogens Conclusion: Yoga associated with beneficial effects on social functioning Birmingham, UK -- supervised aerobic exercise vs. exercise-placebo vs. usual care Randomized. 108 women treated for BCA 1-3 year previously. Assigned to 1) supervised aerobic exercise vs. 2) exercise-placebo vs. 3) usual care. Exercise 3x/week x 8 weeks 2007 PMID 17470863 -- "Randomized trial of exercise therapy in women treated for breast cancer." (Daley AJ, J Clin Oncol. 2007 May 1;25(13):1713-21.) Outcome: Significant benefit in functional outcome and QoL in Arm 1, but not Arm 2 (therefore not result of attention) Conclusion: Exercise had large, clinically meaningful benefit on QoL Prostate Cancer Perth, Australia (2007-2008) -- exercise x12 weeks vs control Randomized. 57 patients with CaP, undergoing AST. Arm 1) resistance and aerobic exercise x12 weeks vs. Arm 2) usual care. Primary endpoint lean mass 2010 PMID 19949016 -- "Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial." (Galvao DA, J Clin Oncol. 2010 Jan 10;28(2):340-7. Epub 2009 Nov 30.) Outcome: Patients undergoing exercise improved lean mass (SS), muscle strength (SS), improved walk time (SS), QoL (SS), fatigue (SS), and CRP levels (SS) Conclusion: Relatively brief exposure to exercise significantly improved AST-related adverse effects Rochester -- exercise x4 weeks vs. control Randomized. 38 breast or prostate cancer patients. Arm 1) Home-based aerobic and progressive resistance exercise x4 weeks at start of RT vs. Arm 2) control. 2009 PMID 19831159 -- "A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial." (Mustian KM, J Support Oncol. 2009 Sep-Oct;7(5):158-67.) Outcome: Good adherence to intervention. At 3 months, significantly more daily steps walked, daily minutes of resistance exercise, number of resistance exercise days. Also significantly higher QoL and significantly lower cancer-related fatigue Conclusion: Exercise during RT may be beneficial for cancer patients Houston VA -- exercise x8 weeks vs. control Randomized. 21 patients with localized PCA, undergoing therapy. Arm 1) RT + aerobic exercise 3x/week x8 weeks vs. Arm 2) RT only 2007 PMID 17964881 -- "Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy." (Monga U, Arch Phys Med Rehabil. 2007 Nov;88(11):1416-22.) Outcome: Significant benefit in fatigue, cardiac fitness, strength, flexibility, FACT-P, physical well-being, social well-being, and functional well-being Conclusion: 8-week cardiovascular program during RT improves fatigues, well-being, and fitness