title: Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial.
abstract: OBJECTIVE
  Few randomized controlled trials in exercise oncology have examined survival outcomes. Here, we report an exploratory follow-up of progression-free survival (PFS) from the Healthy Exercise for Lymphoma Patients (HELP) Trial.
  
  
  METHODS
  The HELP Trial randomized 122 lymphoma patients between 2005 and 2008 to either control (n = 62) or 12 weeks of supervised aerobic exercise (n = 60). PFS events were abstracted from medical records in 2013. In addition to the randomized comparison, we explored the effects of exercise adherence (<80 % vs. ≥80 %) and control group crossover (no vs. yes).
  
  
  RESULTS
  After a median follow-up of 61 months (interquartile range 36-67), the adjusted 5-year PFS was 64.8 % for the exercise group compared with 65.0 % for the control group (Hazard ratio [HR] 1.01, 95 % CI 0.51-2.01, p = 0.98). In the secondary analysis, the adjusted 5-year PFS was 59.0 % in the control group without crossover compared with 69.2 % for the control group with crossover (HR 0.68, 95 % CI 0.22-2.06, p = 0.49), 67.7 % for the exercise group with <80 % adherence (HR 0.72, 95 % CI 0.28-1.85, p = 0.50), and 68.4 % for the exercise group with ≥80 % adherence (HR 0.70, 95 % CI 0.32-1.56, p = 0.39). In a post hoc analysis combining the three groups that received supervised exercise, the adjusted 5-year PFS for the supervised exercise groups was 68.5 % compared with 59.0 % for the group that received no supervised exercise (HR 0.70, 95 % CI 0.35-1.39, p = 0.31).
  
  
  CONCLUSIONS
  This exploratory follow-up of the HELP Trial suggests that supervised aerobic exercise may be associated with improved PFS in lymphoma patients. Larger trials designed to answer this question are needed.
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada. kerry.courneya@ualberta.ca.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
authors.affiliation: School of Public Health, University of Alberta, Edmonton, AB, Canada.
authors.forename: Conrado
authors.initials: C
authors.lastname: Franco-Villalobos
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Crawford
authors.affiliation: Department of Oncology, University of Alberta, Edmonton, AB, Canada.|Cross Cancer Institute, Edmonton, AB, Canada.
authors.forename: Neil
authors.initials: N
authors.lastname: Chua
authors.affiliation: Department of Oncology, University of Alberta, Edmonton, AB, Canada.|Cross Cancer Institute, Edmonton, AB, Canada.
authors.forename: Sanraj
authors.initials: S
authors.lastname: Basi
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Norris
authors.affiliation: Department of Oncology, Saint John Regional Hospital, Saint John, NB, Canada.|Department of Biology, University of New Brunswick, Saint John, NB, Canada.|Department of Medicine, Dalhousie University, Halifax, NS, Canada.
authors.forename: Tony
authors.initials: T
authors.lastname: Reiman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D018572:Disease-Free Survival; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult