Immediate versus delayed exercise in men initiating androgen deprivation: effects on bone density and soft tissue composition.
Absorptiometry, Photon
Adipose Tissue
/ diagnostic imaging
Aged
Aged, 80 and over
Androgen Antagonists
/ adverse effects
Antineoplastic Agents, Hormonal
/ adverse effects
Body Composition
/ drug effects
Bone Density
/ drug effects
Exercise
/ physiology
Humans
Male
Middle Aged
Muscle, Skeletal
/ diagnostic imaging
Prostate-Specific Antigen
/ blood
Prostatic Neoplasms
/ blood
Single-Blind Method
Testosterone
/ blood
Time Factors
Tomography, X-Ray Computed
#PCSM
#ProstateCancer
androgen-deprivation therapy
exercise
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
pubmed:
22
9
2018
medline:
29
9
2019
entrez:
22
9
2018
Statut:
ppublish
Résumé
To examine whether it is more efficacious to commence exercise medicine in men with prostate cancer at the onset of androgen-deprivation therapy (ADT) rather than later on during treatment to preserve bone and soft-tissue composition, as ADT results in adverse effects including: reduced bone mineral density (BMD), loss of muscle mass, and increased fat mass (FM). In all, 104 patients with prostate cancer, aged 48-84 years initiating ADT, were randomised to immediate exercise (IMEX, n = 54) or delayed exercise (DEL, n = 50) conditions. The former consisted of 6 months of supervised resistance/aerobic/impact exercise and the latter comprised 6 months of usual care followed by 6 months of the identical exercise programme. Regional and whole body BMD, lean mass (LM), whole body FM and trunk FM, and appendicular skeletal muscle (ASM) were assessed by dual X-ray absorptiometry, and muscle density by peripheral quantitative computed tomography at baseline, and at 6 and 12 months. There was a significant time effect (P < 0.001) for whole body, spine and hip BMD with a progressive loss in the IMEX and DEL groups, although lumbar spine BMD was largely preserved in the IMEX group at 6 months compared with the DEL group (-0.4% vs -1.6%). LM, ASM, and muscle density were preserved in the IMEX group at 6 months, declined in the DEL group at 6 months (-1.4% to -2.5%) and then recovered at 12 months after training. FM and trunk FM increased (P < 0.001) over the 12-month period in the IMEX (7.8% and 4.5%, respectively) and DEL groups (6.5% and 4.3%, respectively). Commencing exercise at the onset of ADT preserves lumbar spine BMD, muscle mass, and muscle density. To avoid treatment-related adverse musculoskeletal effects, exercise medicine should be prescribed and commenced at the onset of ADT.
Identifiants
pubmed: 30239116
doi: 10.1111/bju.14505
pmc: PMC6635752
doi:
Substances chimiques
Androgen Antagonists
0
Antineoplastic Agents, Hormonal
0
Testosterone
3XMK78S47O
Prostate-Specific Antigen
EC 3.4.21.77
Banques de données
ANZCTR
['ACTRN12612000097842']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
261-269Informations de copyright
© 2018 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.
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