title: Feasibility of a 12-month-exercise intervention during and after radiation and chemotherapy in cancer patients: impact on quality of life, peak oxygen consumption, and body composition.
abstract: BACKGROUND
  Accumulating evidence suggests that exercise is effective in treating many of the acute and chronic side effects of anti-cancer therapy. A recent meta-analysis supported the use of exercise to prevent or treat fatigue and lymphoedema and to improve functional status in breast cancer patients.
  
  
  METHODS
  This trial was intended as a controlled, prospective feasibility study evaluating the impact of physical exercise (PE) in cancer patients during and after treatment with radio- and chemotherapy. Inclusion criteria were previous or ongoing treatment for cancer, motivation for PE of 0.5-1hour duration at least twice weekly for at least 3 months. Continuation of PE was encouraged thereafter. Every three months the following endpoints were assessed: Peak oxygen consumption as measured by supervised cardiopulmonary exercise test, body composition and quality of life.
  
  
  RESULTS
  A total of 45 patients were included with a median age of 49 years. Forty were female and five male. Cancer types were: Breast cancer (n = 30/67 %), gastrointestinal cancer (n = 5/12 %), other types (n = 10/22 %). Thirty-eight (84 %) of the patients were included during curative treatment of their disease. Seven (16 %) were considered palliative. Adherence to the PE-programme longer than 6 months was noted for 41/45 (91 %) of the patients. Intensity of PE was thrice weekly in 32/45 (71 %), twice weekly in 11/45 (24 %). Two of 45 patients (5 %) had no PE. Mean peak oxygen consumption increased from 18.8 ± 5.6 ml/min/kg to 20.5 ± 3 ml/min/kg and 19.9 ± 4.7 ml/min/kg at 3 months (p = 0.005) and 12 months (p = 0.003), respectively. Median fat mass decreased from 30.7 ± 15 kg to 28.9 ± 15 kg and 29.5 ± 13 kg at 3 months (p = 0.001) and 12 months (p = 0.017), respectively. Global health status scores increased from a median baseline value of 54.9 ± 16.3 to 66.4 ± 14 % and 68.0 ± 20.3 % at 3 months (p = 0.001) and 12 months (p = 0.002), respectively.
  
  
  CONCLUSIONS
  This exercise programme in cancer patients with 2-3 weekly supervised sessions over three months was well feasible and demonstrated measurable improvement of oxygen consumption, body composition and quality of life. In addition, a 90 %-adherence rate to the PE-programme beyond 6 months was encouraging. Further randomized prospective data in a larger patient population will be collected comparing the impact of two versus four months supervision.
authors.affiliation: Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Grabenbauer
authors.affiliation: Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Grabenbauer
authors.affiliation: Fresenius Kabi Deutschland, Bad Homburg, Germany.
authors.forename: Rosa
authors.initials: R
authors.lastname: Lengenfelder
authors.affiliation: Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany.
authors.forename: Gerhard G
authors.initials: GG
authors.lastname: Grabenbauer
authors.affiliation: Department of Radiation Oncology of the University Hospitals and Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. luitpold.distel@uk-erlangen.de.
authors.forename: Luitpold V
authors.initials: LV
authors.lastname: Distel
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D004358:Drug Therapy; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000517:prevention & control / Q000628:therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000523:psychology / Q000628:therapy; D006801:Humans; D008209:Lymphedema / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy* / Q000628:therapy*; D010101:Oxygen Consumption; D011446:Prospective Studies; D011788:Quality of Life; D011878:Radiotherapy; D016896:Treatment Outcome
keywords: Body composition; Cancer patients; Exercise intervention; Peak oxygen consumption; Physical exercise; Quality of life