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

被引：462

作者：

van Waart, Hanna ^{[1
]}

Stuiver, Martijn M. ^{[1
]}

van Harten, Wim H. ^{[1
]}

Geleijn, Edwin ^{[2
]}

Kieffer, Jacobien M. ^{[1
]}

Buffart, Laurien M. ^{[2
,3
]}

de Maaker-Berkhof, Marianne ^{[1
]}

Boven, Epie ^{[2
]}

Schrama, Jolanda ^{[7
]}

Geenen, Maud M. ^{[4
]}

Terwogt, Jetske M. Meerum ^{[5
]}

van Bochove, Aart ^{[8
,9
]}

Lustig, Vera ^{[10
]}

van den Heiligenberg, Simone M. ^{[8
,11
]}

Smorenburg, Carolien H. ^{[12
]}

Hellendoorn-van Vreeswijk, Jeannette A. J. H. ^{[6
]}

Sonke, Gabe S. ^{[1
]}

Aaronson, Neil K. ^{[1
]}

机构：

[1] Netherlands Canc Inst, NL-1066 CX Amsterdam, Netherlands

[2] Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands

[3] EMGO Inst Hlth & Care Res, Amsterdam, Netherlands

[4] Sint Lucas Andreas Hosp, Amsterdam, Netherlands

[5] Onze Lieve Vrouw Hosp, Amsterdam, Netherlands

[6] Comprehens Canc Ctr Netherlands, Amsterdam, Netherlands

[7] Spaarne Hosp, Hoofddorp, Netherlands

[8] Esperanza Fdn, North Holland, Netherlands

[9] Zaans Med Cent, Zaandam, Netherlands

[10] Flevohosp, Almere, Netherlands

[11] Westfries Gasthuis, Hoorn, Netherlands

[12] Med Ctr Alkmaar, Alkmaar, Netherlands

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2015年 / 33卷 / 17期

关键词：

BREAST-CANCER PATIENTS; MEDICAL-TREATMENT; WOMEN; INTERVENTION; TRASTUZUMAB; STRENGTH; BEHAVIOR;

D O I：

10.1200/JCO.2014.59.1081

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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. (C) 2015 by American Society of Clinical Oncology

引用

页码：1918 / U90

页数：12

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