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Effect of Baseline Status on Benefit From Exercise Interventions in Patients With Cancer

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Key Points

  • Patients with baseline high fatigue and low physical function benefited most from both during-treatment and posttreatment exercise interventions.
  • Patients experienced benefit in muscle strength and quality of life from during-treatment interventions irrespective of baseline values. 

In a study reported in the Journal of the National Cancer Institute, Buffart et al found that patients with cancer benefited more or less from exercise interventions depending on their baseline condition and timing of the intervention.

The study was an individual patient data meta-analysis involving 4,519 patients from 34 randomized trials of exercise interventions. Linear mixed-effect models were used to assess the effects of baseline values on intervention outcomes and to evaluate whether these effects differed according to whether the exercise intervention was during treatment or posttreatment.

Effects of Baseline Status on Effect of Intervention

The effects of baseline fatigue and physical function were consistent for both during-treatment and posttreatment interventions, with greater effects of the intervention being observed in patients with worse fatigue (P for interaction = .05) and worse physical function (P for interaction = .003) at baseline. The effects of baseline aerobic fitness, muscle strength, and quality of life on effects of the exercise intervention differed according to timing of the intervention.

For interventions during treatment, effects on aerobic fitness were greater among patients with better baseline aerobic fitness (P for interaction = .002). For posttreatment interventions, effects on upper body muscle strength (P for interaction < .001), lower body muscle strength (P for interaction = .01), and quality of life (P for interaction < .001) were greater among patients with worse baseline values.

The investigators concluded, “Although exercise should be encouraged for most [patients with] cancer during and posttreatments, targeting specific subgroups may be especially beneficial and cost-effective. For fatigue and [physical function], interventions during and posttreatment should target patients with [baseline] high fatigue and low [physical function]. During treatment, patients experience benefit for muscle strength and [quality of life] regardless of baseline values; however, only patients with low baseline values benefit posttreatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.”

This work was supported by the Alpe d’HuZes foundation/Dutch Cancer Society.

Laurien M. Buffart, PhD, of the Department of Epidemiology and Biostatistics and Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, is the corresponding author for the Journal of the National Cancer Institute article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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