Optimal Timing of a Physical Exercise Intervention to Improve Cardiorespiratory Fitness During or After Chemotherapy

被引：35

作者：

van der Schoot, Gabriela G. F. ^{[1
]}

Ormel, Harm L. ^{[1
]}

Westerink, Nico-Derk L. ^{[1
]}

May, Anne M. ^{[2
]}

Elias, Sjoerd G. ^{[2
]}

Hummel, Yoran M. ^{[3
]}

Lefrandt, Joop D. ^{[4
]}

Van der Meer, Peter ^{[5
]}

Van Melle, Joost P. ^{[5
]}

Poppema, Boelo J. ^{[1
,6
]}

Stel, Joyce M. A. ^{[7
]}

Van der Velden, Annette W. G. ^{[8
]}

Vrieling, Aline H. ^{[7
]}

Wempe, Johan B. ^{[3
]}

Ten Wolde, Marcel G. ^{[7
]}

Nijland, Marcel ^{[9
]}

De Vries, Elisabeth G. E. ^{[1
]}

Gietema, Jourik A. ^{[1
]}

Walenkamp, Annemiek M. E. ^{[1
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[2] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[3] Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Med, Groningen, Netherlands

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Vasc Med, Groningen, Netherlands

[5] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[6] Ommelander Hosp Groningen, Dept Internal Med, Scheemda, Netherlands

[7] Univ Groningen, Univ Med Ctr Groningen, Dept Rehabil Med, Groningen, Netherlands

[8] Martini Hosp Groningen, Dept Internal Med, Groningen, Netherlands

[9] Univ Groningen, Univ Med Ctr Groningen, Dept Hematol, Groningen, Netherlands

来源：

JACC: CARDIOONCOLOGY | 2022年 / 4卷 / 04期

关键词：

cardiorespiratory fitness; chemotherapy; fatigue; muscle strength; physical exercise; quality of life; CANCER-RELATED FATIGUE; QUALITY-OF-LIFE; EFFICACY; EVENTS; SCALE; RISK;

D O I：

10.1016/j.jaccao.2022.07.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BACKGROUND Despite the widely acknowledged benefit of exercise for patients with cancer, little evidence on the optimal timing of exercise on adverse effects of cancer treatment is available. OBJECTIVES The aim of this study was to determine whether an exercise intervention initiated during chemotherapy is superior to an intervention initiated after chemotherapy for improving long-term cardiorespiratory fitness (peak oxygen uptake [VO2peak]). METHODS In this prospective, randomized clinical trial, patients scheduled to receive curative chemotherapy were randomized to a 24-week exercise intervention, initiated either during chemotherapy (group A) or afterward (group B). The primary endpoint was VO2peak 1 year postintervention. Secondary endpoints were VO2peak postintervention, muscle strength, health-related quality of life (HRQoL), fatigue, physical activity, and self-efficacy. Between-group differences were calculated using intention-to-treat linear mixed-models analyses. RESULTS A total of 266 patients with breast (n = 139), testicular (n = 95), and colon cancer (n = 30) as well as lymphoma (n = 2) were included. VO2peak immediately postintervention and 1 year postintervention did not differ between the 2 groups. Immediately postchemotherapy, patients in group A exhibited significantly lower decreases in VO2peak (3.1 mL/kg/min; 95% CI: 2.2-4.0 mL/kg/min), HRQoL, and muscle strength and reported less fatigue and more physical activity than those in group B. CONCLUSIONS Exercise can be safely performed during chemotherapy and prevents fatigue and decreases in VO2peak, muscle strength, and HRQoL, in addition to hastening the return of function after chemotherapy. Also, if exercise cannot be performed during chemotherapy, a program afterward can enable patients to regain the same level of function, measured 1 year after completion of the intervention. (c) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：491 / 503

页数：13

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