Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial

Hanna van Waart; Martijn M. Stuiver; Wim H. van Harten; Edwin Geleijn; Jacobien M. Kieffer; Laurien M. Buffart; Marianne de Maaker-Berkhof; Epie Boven; Jolanda Schrama; Maud M. Geenen; Jetske M. Meerum Terwogt; Aart van Bochove; Vera Lustig; Simone M. van den Heiligenberg; Carolien H. Smorenburg; Jeannette A. J. H. Hellendoorn-van Vreeswijk; Gabe S. Sonke; Neil K. Aaronson

doi:10.1200/JCO.2014.59.1081

Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial

Hanna van Waart
, Martijn M. Stuiver
, Wim H. van Harten
, Edwin Geleijn
, Jacobien M. Kieffer
, Laurien M. Buffart
, Marianne de Maaker-Berkhof
, Epie Boven
, Jolanda Schrama
, Maud M. Geenen
, Jetske M. Meerum Terwogt
, Aart van Bochove
, Vera Lustig
, Simone M. van den Heiligenberg
, Carolien H. Smorenburg
, Jeannette A. J. H. Hellendoorn-van Vreeswijk
, Gabe S. Sonke
, Neil K. Aaronson

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

We evaluated the effectiveness of a low-intensity, home-based physical activity program (Onco-Move) and a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack) versus usual care (UC) in maintaining or enhancing physical fitness, minimizing fatigue, enhancing health-related quality of life, and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer. We randomly assigned patients who were scheduled to undergo adjuvant chemotherapy (N = 230) to Onco-Move, OnTrack, or UC. Performance-based and self-reported outcomes were assessed before random assignment, at the end of chemotherapy, and at the 6-month follow-up. We used generalized estimating equations to compare the groups over time. Onco-Move and OnTrack resulted in less decline in cardiorespiratory fitness (P <.001), better physical functioning (P ≤ .001), less nausea and vomiting (P = .029 and .031, respectively) and less pain (P = .003 and .011, respectively) compared with UC. OnTrack also resulted in better outcomes for muscle strength (P = .002) and physical fatigue (P <.001). At the 6-month follow-up, most outcomes returned to baseline levels for all three groups. A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups (P = .002). Both intervention groups returned earlier (P = .012), as well as for more hours per week (P = .014), to work than the control group. A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program

Original language	English
Pages (from-to)	1918-1927
Journal	Journal of clinical oncology
Volume	33
Issue number	17
DOIs	https://doi.org/10.1200/JCO.2014.59.1081
Publication status	Published - 2015

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van Waart, H., Stuiver, M. M., van Harten, W. H., Geleijn, E., Kieffer, J. M., Buffart, L. M., de Maaker-Berkhof, M., Boven, E., Schrama, J., Geenen, M. M., Meerum Terwogt, J. M., van Bochove, A., Lustig, V., van den Heiligenberg, S. M., Smorenburg, C. H., Hellendoorn-van Vreeswijk, J. A. J. H., Sonke, G. S., & Aaronson, N. K. (2015). Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. Journal of clinical oncology, 33(17), 1918-1927. https://doi.org/10.1200/JCO.2014.59.1081

van Waart, Hanna ; Stuiver, Martijn M. ; van Harten, Wim H. et al. / Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. In: Journal of clinical oncology. 2015 ; Vol. 33, No. 17. pp. 1918-1927.

@article{d53e2d06584347bf9738b39cd7575e6e,

title = "Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial",

abstract = "We evaluated the effectiveness of a low-intensity, home-based physical activity program (Onco-Move) and a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack) versus usual care (UC) in maintaining or enhancing physical fitness, minimizing fatigue, enhancing health-related quality of life, and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer. We randomly assigned patients who were scheduled to undergo adjuvant chemotherapy (N = 230) to Onco-Move, OnTrack, or UC. Performance-based and self-reported outcomes were assessed before random assignment, at the end of chemotherapy, and at the 6-month follow-up. We used generalized estimating equations to compare the groups over time. Onco-Move and OnTrack resulted in less decline in cardiorespiratory fitness (P <.001), better physical functioning (P ≤ .001), less nausea and vomiting (P = .029 and .031, respectively) and less pain (P = .003 and .011, respectively) compared with UC. OnTrack also resulted in better outcomes for muscle strength (P = .002) and physical fatigue (P <.001). At the 6-month follow-up, most outcomes returned to baseline levels for all three groups. A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups (P = .002). Both intervention groups returned earlier (P = .012), as well as for more hours per week (P = .014), to work than the control group. A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program",

author = "\{van Waart\}, Hanna and Stuiver, \{Martijn M.\} and \{van Harten\}, \{Wim H.\} and Edwin Geleijn and Kieffer, \{Jacobien M.\} and Buffart, \{Laurien M.\} and \{de Maaker-Berkhof\}, Marianne and Epie Boven and Jolanda Schrama and Geenen, \{Maud M.\} and \{Meerum Terwogt\}, \{Jetske M.\} and \{van Bochove\}, Aart and Vera Lustig and \{van den Heiligenberg\}, \{Simone M.\} and Smorenburg, \{Carolien H.\} and \{Hellendoorn-van Vreeswijk\}, \{Jeannette A. J. H.\} and Sonke, \{Gabe S.\} and Aaronson, \{Neil K.\}",

year = "2015",

doi = "10.1200/JCO.2014.59.1081",

language = "English",

volume = "33",

pages = "1918--1927",

journal = "Journal of clinical oncology",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

number = "17",

}

van Waart, H, Stuiver, MM, van Harten, WH, Geleijn, E, Kieffer, JM, Buffart, LM, de Maaker-Berkhof, M, Boven, E, Schrama, J, Geenen, MM, Meerum Terwogt, JM, van Bochove, A, Lustig, V, van den Heiligenberg, SM, Smorenburg, CH, Hellendoorn-van Vreeswijk, JAJH, Sonke, GS & Aaronson, NK 2015, 'Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial', Journal of clinical oncology, vol. 33, no. 17, pp. 1918-1927. https://doi.org/10.1200/JCO.2014.59.1081

Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. / van Waart, Hanna; Stuiver, Martijn M.; van Harten, Wim H. et al.
In: Journal of clinical oncology, Vol. 33, No. 17, 2015, p. 1918-1927.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial

AU - van Waart, Hanna

AU - Stuiver, Martijn M.

AU - van Harten, Wim H.

AU - Geleijn, Edwin

AU - Kieffer, Jacobien M.

AU - Buffart, Laurien M.

AU - de Maaker-Berkhof, Marianne

AU - Boven, Epie

AU - Schrama, Jolanda

AU - Geenen, Maud M.

AU - Meerum Terwogt, Jetske M.

AU - van Bochove, Aart

AU - Lustig, Vera

AU - van den Heiligenberg, Simone M.

AU - Smorenburg, Carolien H.

AU - Hellendoorn-van Vreeswijk, Jeannette A. J. H.

AU - Sonke, Gabe S.

AU - Aaronson, Neil K.

PY - 2015

Y1 - 2015

N2 - We evaluated the effectiveness of a low-intensity, home-based physical activity program (Onco-Move) and a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack) versus usual care (UC) in maintaining or enhancing physical fitness, minimizing fatigue, enhancing health-related quality of life, and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer. We randomly assigned patients who were scheduled to undergo adjuvant chemotherapy (N = 230) to Onco-Move, OnTrack, or UC. Performance-based and self-reported outcomes were assessed before random assignment, at the end of chemotherapy, and at the 6-month follow-up. We used generalized estimating equations to compare the groups over time. Onco-Move and OnTrack resulted in less decline in cardiorespiratory fitness (P <.001), better physical functioning (P ≤ .001), less nausea and vomiting (P = .029 and .031, respectively) and less pain (P = .003 and .011, respectively) compared with UC. OnTrack also resulted in better outcomes for muscle strength (P = .002) and physical fatigue (P <.001). At the 6-month follow-up, most outcomes returned to baseline levels for all three groups. A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups (P = .002). Both intervention groups returned earlier (P = .012), as well as for more hours per week (P = .014), to work than the control group. A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program

AB - We evaluated the effectiveness of a low-intensity, home-based physical activity program (Onco-Move) and a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack) versus usual care (UC) in maintaining or enhancing physical fitness, minimizing fatigue, enhancing health-related quality of life, and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer. We randomly assigned patients who were scheduled to undergo adjuvant chemotherapy (N = 230) to Onco-Move, OnTrack, or UC. Performance-based and self-reported outcomes were assessed before random assignment, at the end of chemotherapy, and at the 6-month follow-up. We used generalized estimating equations to compare the groups over time. Onco-Move and OnTrack resulted in less decline in cardiorespiratory fitness (P <.001), better physical functioning (P ≤ .001), less nausea and vomiting (P = .029 and .031, respectively) and less pain (P = .003 and .011, respectively) compared with UC. OnTrack also resulted in better outcomes for muscle strength (P = .002) and physical fatigue (P <.001). At the 6-month follow-up, most outcomes returned to baseline levels for all three groups. A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups (P = .002). Both intervention groups returned earlier (P = .012), as well as for more hours per week (P = .014), to work than the control group. A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program

U2 - 10.1200/JCO.2014.59.1081

DO - 10.1200/JCO.2014.59.1081

M3 - Article

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SN - 0732-183X

VL - 33

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EP - 1927

JO - Journal of clinical oncology

JF - Journal of clinical oncology

IS - 17

ER -

van Waart H, Stuiver MM, van Harten WH, Geleijn E, Kieffer JM, Buffart LM et al. Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. Journal of clinical oncology. 2015;33(17):1918-1927. doi: 10.1200/JCO.2014.59.1081