Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis

Document Type

Journal Article

Publication Title

Journal of the National Cancer Institute

Publisher

Oxford University Press

School

Exercise Medicine Research Institute

RAS ID

29535

Comments

Buffart, L. M., Sweegers, M. G., May, A. M., Chinapaw, M. J., van Vulpen, J. K., Newton, R. U., ... & Verdonck-de Leeuw, I. M. (2018). Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis. JNCI: Journal of the National Cancer Institute, 110(11), 1190-1200.

Available here.

Abstract

Background

Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods

Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results

Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion

Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

DOI

10.1093/jnci/djy161

Access Rights

free_to_read

Link to Full Text

Share

 
COinS