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Randomized Controlled Trial
. 2013 Dec 4;105(23):1821-32.
doi: 10.1093/jnci/djt297. Epub 2013 Oct 22.

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

Kerry S Courneya  1 , 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
Affiliations
Randomized Controlled Trial

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

Kerry S Courneya et al. J Natl Cancer Inst. .

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.

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