JCO Early Release, published online ahead of print Sep 4 2007
Journal of Clinical Oncology, 10.1200/JCO.2006.08.2024
Received July 7, 2006
Accepted March 8, 2007
Effects of Aerobic and Resistance Exercise in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Multicenter Randomized Controlled Trial
Kerry S. Courneya,* Roanne J. Segal, John R. Mackey, Karen Gelmon, Robert D. Reid, Christine M. Friedenreich, Aliya B. Ladha, Caroline Proulx, Jeffrey K.H. Vallance, Kirstin Lane, Yutaka Yasui, and Donald C. McKenzie
From the University of Alberta; Cross Cancer Institute, Edmonton; Alberta Cancer Board, Calgary, Alberta; Ottawa Hospital Regional Cancer Center; University of Ottawa Heart Institute, Ottawa, Ontario; British Columbia Cancer Agency; and the University of British Columbia, Vancouver, British Columbia, Canada.
* To whom correspondence should be addressed. E-mail: kerry.courneya{at}ualberta.ca
Purpose: Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects.
Patients and Methods: We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy–Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema.
Results: The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem (P = .015), aerobic fitness (P = .006), and percent body fat (adjusted P = .076). Resistance exercise was superior to usual care for improving self-esteem (P = .018), muscular strength (P < .001), lean body mass (P = .015), and chemotherapy completion rate (P = .033). Changes in cancer-specific QOL, fatigue, depression, and anxiety favored the exercise groups but did not reach statistical significance. Exercise did not cause lymphedema or adverse events.
Conclusion: Neither aerobic nor resistance exercise significantly improved cancer-specific QOL in breast cancer patients receiving chemotherapy, but they did improve self-esteem, physical fitness, body composition, and chemotherapy completion rate without causing lymphedema or significant adverse events.
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