Originally published as JCO Early Release 10.1200/JCO.2008.20.0634 on August 17 2009

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Randomized Controlled Trial of the Effects of Aerobic Exercise on Physical Functioning and Quality of Life in Lymphoma Patients

From the University of Alberta; Cross Cancer Institute, Edmonton; Alberta Cancer Board, Calgary, Alberta, Canada; and University of Manchester, Manchester, United Kingdom.

Corresponding author: Kerry S. Courneya, PhD, Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, Canada T6G 2H9; e-mail: kerry.courneya{at}ualberta.ca.

Purpose Lymphoma patients commonly experience declines in physical functioning and quality of life (QoL) that may be reversed with exercise training.

Patients and Methods We conducted a randomized controlled trial in Edmonton, Alberta, Canada, between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and randomly assigned them to usual care (UC; n = 62) or 12 weeks of supervised aerobic exercise training (AET; n = 60). Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia. Secondary end points were overall QoL, psychosocial functioning, cardiovascular fitness, and body composition.

Results Follow-up assessment for our primary end point was 96% (117 of 122) at postintervention and 90% (110 of 122) at 6-month follow-up. Median adherence to the supervised exercise program was 92%. At postintervention, AET was superior to UC for patient-rated physical functioning (mean group difference, +9.0; 95% CI, 2.0 to 16.0; P = .012), overall QoL (P = .021), fatigue (P = .013), happiness (P = .004), depression (P = .005), general health (P < .001), cardiovascular fitness (P < .001), and lean body mass (P = .008). Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning. AET did not interfere with chemotherapy completion rate or treatment response. At 6-month follow-up, AET was still borderline or significantly superior to UC for overall QoL (P = .054), happiness (P = .034), and depression (P = .009) without an increased risk of disease recurrence/progression.

Conclusion AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response. Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients.

Supported by the Lance Armstrong Foundation. Additional support provided by the Canada Research Chairs Program (K.S.C.); by Health Studentships (C.M.S. and C.J.P.), Senior Health Scholar Award (C.M.F.), and Clinical Investigator Award (T.R.) from the Alberta Heritage Foundation for Medical Research; by Research Team Grant No. 010282 from the National Cancer Institute of Canada (NCIC); and by the Canadian Cancer Society (CCS) and the NCIC/CCS Sociobehavioral Cancer Research Network (K.S.C. and C.M.F.).

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Clinical Trials repository link available on JCO.org.

Clinical trial information can be found for the following: NCT00111865 [ClinicalTrials.gov] .

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