Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial

Kerry S. Courneya, Donald C. McKenzie, John R. Mackey, Karen Gelmon, Christine M. Friedenreich, Yutaka Yasui, Robert D. Reid, Diane Cook, Diana Jespersen, Carolyn Proulx, Lianne B. Dolan, Cynthia C. Forbes, Evyanne Wooding, Linda Trinh, Roanne J. Segal

Research output: Contribution to journalArticlepeer-review

Abstract

Background Exercise improves physical functioning and symptom management during breast cancer chemotherapy, but the effects of different doses and types of exercise are unknown. Methods A multicenter trial in Canada randomized 301 breast cancer patients to thrice-weekly supervised exercise during chemotherapy consisting of either a standard dose of 25 to 30 minutes of aerobic exercise (STAN; n = 96), a higher dose of 50 to 60 minutes of aerobic exercise (HIGH; n = 101), or a combined dose of 50 to 60 minutes of aerobic and resistance exercise (COMB; n = 104). The primary endpoint was physical functioning assessed by the Medical Outcomes Survey-Short Form (SF)-36. Secondary endpoints were other physical functioning scales, symptoms, fitness, and chemotherapy completion. All statistical tests were linear mixed model analyses, and the P values were two-sided. Results Follow-up assessment of patient-reported outcomes was 99.0%. Adjusted linear mixed-model analyses showed that neither HIGH (+0.8; 95% confidence interval [CI] = -0.8 to 2.4; P = .30) nor COMB (+0.5; 95% CI = -1.1 to 2.1; P = .52] were superior to STAN for the primary outcome. In secondary analyses not adjusted for multiple comparisons, HIGH was superior to STAN for the SF-36 physical component summary (P = .04), SF-36 bodily pain (P = .02), and endocrine symptoms (P = .02). COMB was superior to STAN for endocrine symptoms (P = .009) and superior to STAN (P < .001) and HIGH (P < .001) for muscular strength. HIGH was superior to COMB for the SF-36 bodily pain (P = .04) and aerobic fitness (P = .03). No differences emerged for body composition or chemotherapy completion. Conclusions A higher volume of aerobic or combined exercise is achievable and safe during breast cancer chemotherapy and may manage declines in physical functioning and worsening symptoms better than standard volumes.

Original languageEnglish (US)
Pages (from-to)1821-1832
Number of pages12
JournalJournal of the National Cancer Institute
Volume105
Issue number23
DOIs
StatePublished - Dec 4 2013

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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