TY - JOUR
T1 - Moderators of the effects of exercise training in breast cancer patients receiving chemotherapy
T2 - A randomized controlled trial
AU - Courneya, Kerry S.
AU - McKenzie, Donald C.
AU - Mackey, John R.
AU - Gelmon, Karen
AU - Reid, Robert D.
AU - Friedenreich, Christine M.
AU - Ladha, Aliya B.
AU - Proulx, Caroline
AU - Vallance, Jeffrey K.
AU - Lane, Kirstin
AU - Yasui, Yutaka
AU - Segal, Roanne J.
PY - 2008/4/15
Y1 - 2008/4/15
N2 - BACKGROUND. Exercise training improves supportive care outcomes in patients with breast cancer who are receiving adjuvant therapy, but the responses are heterogeneous. In this study, the authors examined personal and clinical factors that may predict exercise training responses. METHODS. Breast cancer patients who were initiating adjuvant chemotherapy (N = 242) were assigned randomly to receive usual care (UC) (n = 82), resistance exercise training (RET) (n = 82), or aerobic exercise training (AET) (n = 78) for the duration of chemotherapy. Endpoints were quality of life (QoL), aerobic fitness, muscular strength, lean body mass, and body fat. Moderators were patient preference for group assignment, marital status, age, disease stage, and chemotherapy regimen. RESULTS. Adjusted linear mixed-model analyses demonstrated that patient preference moderated QoL response (P = .005). Patients who preferred RET improved QoL when they were assigned to receive RET compared with UC (mean difference, 16.5; 95% confidence interval [95% CI], 4.3-28.7; P =.008) or AET (mean difference, 11; 95% CI, -1.1-23.4; P =.076). Patients who had no preference had improved QoL when they were assigned to receive AET compared with RET (mean difference, 23; 95% CI, 4.9-41; P = .014). Marital status also moderated QoL response (P = .026), age moderated aerobic fitness response (P = .029), chemotherapy regimen moderated strength gain (P = .009), and disease stage moderated both lean body mass gain (P < .001) and fat loss (P = .059). Unmarried, younger patients who were receiving nontaxane-based therapies and had more advanced disease stage experienced better outcomes. The findings were not explained by differences in adherence. CONCLUSIONS. Patient preference, demographic variables, and medical variables moderated the effects of exercise training in breast cancer patients who were receiving chemotherapy. If replicated, these results may inform clinical practice.
AB - BACKGROUND. Exercise training improves supportive care outcomes in patients with breast cancer who are receiving adjuvant therapy, but the responses are heterogeneous. In this study, the authors examined personal and clinical factors that may predict exercise training responses. METHODS. Breast cancer patients who were initiating adjuvant chemotherapy (N = 242) were assigned randomly to receive usual care (UC) (n = 82), resistance exercise training (RET) (n = 82), or aerobic exercise training (AET) (n = 78) for the duration of chemotherapy. Endpoints were quality of life (QoL), aerobic fitness, muscular strength, lean body mass, and body fat. Moderators were patient preference for group assignment, marital status, age, disease stage, and chemotherapy regimen. RESULTS. Adjusted linear mixed-model analyses demonstrated that patient preference moderated QoL response (P = .005). Patients who preferred RET improved QoL when they were assigned to receive RET compared with UC (mean difference, 16.5; 95% confidence interval [95% CI], 4.3-28.7; P =.008) or AET (mean difference, 11; 95% CI, -1.1-23.4; P =.076). Patients who had no preference had improved QoL when they were assigned to receive AET compared with RET (mean difference, 23; 95% CI, 4.9-41; P = .014). Marital status also moderated QoL response (P = .026), age moderated aerobic fitness response (P = .029), chemotherapy regimen moderated strength gain (P = .009), and disease stage moderated both lean body mass gain (P < .001) and fat loss (P = .059). Unmarried, younger patients who were receiving nontaxane-based therapies and had more advanced disease stage experienced better outcomes. The findings were not explained by differences in adherence. CONCLUSIONS. Patient preference, demographic variables, and medical variables moderated the effects of exercise training in breast cancer patients who were receiving chemotherapy. If replicated, these results may inform clinical practice.
KW - Aerobic fitness
KW - Body fat
KW - Lean body mass
KW - Patient preference
KW - Quality of life
KW - Resistance exercise training
UR - http://www.scopus.com/inward/record.url?scp=42149159449&partnerID=8YFLogxK
U2 - 10.1002/cncr.23379
DO - 10.1002/cncr.23379
M3 - Journal Article
C2 - 18306372
AN - SCOPUS:42149159449
SN - 0008-543X
VL - 112
SP - 1845
EP - 1853
JO - Cancer
JF - Cancer
IS - 8
ER -
