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Exercise during chemotherapy: Friend or foe?

BACKGROUND: A higher chemotherapy completion rate is associated with better outcomes including treatment efficacy and overall survival. Exercise may have the potential to improve relative dose intensity (RDI) by reducing the frequency and severity of chemotherapy‐related toxicities. We examined the...

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Autores principales: Potiaumpai, Melanie, Schleicher, Erica A., Wang, Ming, Campbell, Kristin L., Sturgeon, Kathleen, Schmitz, Kathryn H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225227/
https://www.ncbi.nlm.nih.gov/pubmed/37076972
http://dx.doi.org/10.1002/cam4.5831
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author Potiaumpai, Melanie
Schleicher, Erica A.
Wang, Ming
Campbell, Kristin L.
Sturgeon, Kathleen
Schmitz, Kathryn H.
author_facet Potiaumpai, Melanie
Schleicher, Erica A.
Wang, Ming
Campbell, Kristin L.
Sturgeon, Kathleen
Schmitz, Kathryn H.
author_sort Potiaumpai, Melanie
collection PubMed
description BACKGROUND: A higher chemotherapy completion rate is associated with better outcomes including treatment efficacy and overall survival. Exercise may have the potential to improve relative dose intensity (RDI) by reducing the frequency and severity of chemotherapy‐related toxicities. We examined the association between exercise adherence and RDI and possible clinical‐ and health‐related fitness predictors of RDI. METHODS: Chemotherapy records were extracted from the electronic medical record for patients enrolled in the ENACT trial (n = 105). Chemotherapy completion was assessed using average RDI. A threshold of 85% was established for “high” versus “low” RDI. Logistic regression analyses were used to estimate the associations between the clinical‐ and health‐related fitness predictors of RDI. RESULTS: Patients with breast cancer (BC) had a significantly higher average RDI (89.8% ± 17.6%) compared with gastrointestinal cancer (GI) (76.8% ± 20.9%, p = 0.004) and pancreatic cancer (PC) (65.2% ± 20.1%, p < 0.001). Only 25% of BC patents required a dose reduction compared to 56.3% of GI and 86.4% of PC patients. Cancer site was significantly associated with RDI. Compared with BC, patients with GI (β = −0.12, p = 0.03) and PC (β = −0.22, p = 0.006) achieved significantly lower RDI. Every 2.72 unit increase in overall exercise adherence led to a significant 7% decrease in RDI (p = 0.001) in GI patients. Metastatic GI patients had a 15% RDI increase for every 2.72 unit increase in exercise adherence (p = 0.04). CONCLUSION: Exercise is a supportive therapy that has potential to enhance chemotherapy tolerance and completion. The relationship between exercise adherence and RDI is influenced by factor such as cancer site and treatment type. Special attention must be paid to how exercise is prescribed to ensure that exercise adherence does not negatively affect RDI. Cancer site, exercise dosage, and multimodal interventions to address toxicities are key areas identified for future research.
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spelling pubmed-102252272023-05-29 Exercise during chemotherapy: Friend or foe? Potiaumpai, Melanie Schleicher, Erica A. Wang, Ming Campbell, Kristin L. Sturgeon, Kathleen Schmitz, Kathryn H. Cancer Med RESEARCH ARTICLES BACKGROUND: A higher chemotherapy completion rate is associated with better outcomes including treatment efficacy and overall survival. Exercise may have the potential to improve relative dose intensity (RDI) by reducing the frequency and severity of chemotherapy‐related toxicities. We examined the association between exercise adherence and RDI and possible clinical‐ and health‐related fitness predictors of RDI. METHODS: Chemotherapy records were extracted from the electronic medical record for patients enrolled in the ENACT trial (n = 105). Chemotherapy completion was assessed using average RDI. A threshold of 85% was established for “high” versus “low” RDI. Logistic regression analyses were used to estimate the associations between the clinical‐ and health‐related fitness predictors of RDI. RESULTS: Patients with breast cancer (BC) had a significantly higher average RDI (89.8% ± 17.6%) compared with gastrointestinal cancer (GI) (76.8% ± 20.9%, p = 0.004) and pancreatic cancer (PC) (65.2% ± 20.1%, p < 0.001). Only 25% of BC patents required a dose reduction compared to 56.3% of GI and 86.4% of PC patients. Cancer site was significantly associated with RDI. Compared with BC, patients with GI (β = −0.12, p = 0.03) and PC (β = −0.22, p = 0.006) achieved significantly lower RDI. Every 2.72 unit increase in overall exercise adherence led to a significant 7% decrease in RDI (p = 0.001) in GI patients. Metastatic GI patients had a 15% RDI increase for every 2.72 unit increase in exercise adherence (p = 0.04). CONCLUSION: Exercise is a supportive therapy that has potential to enhance chemotherapy tolerance and completion. The relationship between exercise adherence and RDI is influenced by factor such as cancer site and treatment type. Special attention must be paid to how exercise is prescribed to ensure that exercise adherence does not negatively affect RDI. Cancer site, exercise dosage, and multimodal interventions to address toxicities are key areas identified for future research. John Wiley and Sons Inc. 2023-04-19 /pmc/articles/PMC10225227/ /pubmed/37076972 http://dx.doi.org/10.1002/cam4.5831 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Potiaumpai, Melanie
Schleicher, Erica A.
Wang, Ming
Campbell, Kristin L.
Sturgeon, Kathleen
Schmitz, Kathryn H.
Exercise during chemotherapy: Friend or foe?
title Exercise during chemotherapy: Friend or foe?
title_full Exercise during chemotherapy: Friend or foe?
title_fullStr Exercise during chemotherapy: Friend or foe?
title_full_unstemmed Exercise during chemotherapy: Friend or foe?
title_short Exercise during chemotherapy: Friend or foe?
title_sort exercise during chemotherapy: friend or foe?
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225227/
https://www.ncbi.nlm.nih.gov/pubmed/37076972
http://dx.doi.org/10.1002/cam4.5831
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