Quality of Life, Fatigue, and Sleep Problems in Pancreatic Cancer Patients—A Randomized Trial on the Effects of Exercise


Journal

Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967

Informations de publication

Date de publication:
08 Jul 2019
Historique:
received: 28 12 2018
revised: 29 04 2019
accepted: 29 04 2019
entrez: 22 8 2019
pubmed: 23 8 2019
medline: 17 6 2020
Statut: ppublish

Résumé

Improving quality of life (QoL) is an important treatment goal in pancreatic cancer patients. Although the beneficial effects of exercise on QoL are well understood, few studies have investigated more aggressive cancers such as pancreatic cancer. Within a randomized trial, we assessed the efficacy of 6-month resistance training on physical functioning (primary outcome) and further QoL-related outcomes. 65 pancreatic cancer patients were assigned to home-based training, supervised training, or a usual care control group. Analysis-of-covariance models on changes from baseline to 6 and 3 months were ap- plied. 47 patients completed the intervention period. After 6 months, no effects of resistance training were observed. However, after 3 months, explorative analyses showed significant between-group mean differences (MD) in favor for resistance training for physical functioning (pooled group: MD=11.0; p=0.016; effect size[ES]=0.31), as well as for global QoL (MD=12.1; p=0.016; effect size=0.56), and other outcomes, such as sleep problems and fatigue. Multiple imputation analyses yielded similar results. Home-based and supervised training performed similarly. This first randomized resistance training trial in pancreatic cancer patients indicated clinically relevant improve- ments in QoL after 3 but not after 6 months. Given the severity of pancreatic cancer, exercise recommendations may already commence at surgery.

Sections du résumé

BACKGROUND
Improving quality of life (QoL) is an important treatment goal in pancreatic cancer patients. Although the beneficial effects of exercise on QoL are well understood, few studies have investigated more aggressive cancers such as pancreatic cancer.
METHODS
Within a randomized trial, we assessed the efficacy of 6-month resistance training on physical functioning (primary outcome) and further QoL-related outcomes. 65 pancreatic cancer patients were assigned to home-based training, supervised training, or a usual care control group. Analysis-of-covariance models on changes from baseline to 6 and 3 months were ap- plied.
RESULTS
47 patients completed the intervention period. After 6 months, no effects of resistance training were observed. However, after 3 months, explorative analyses showed significant between-group mean differences (MD) in favor for resistance training for physical functioning (pooled group: MD=11.0; p=0.016; effect size[ES]=0.31), as well as for global QoL (MD=12.1; p=0.016; effect size=0.56), and other outcomes, such as sleep problems and fatigue. Multiple imputation analyses yielded similar results. Home-based and supervised training performed similarly.
CONCLUSION
This first randomized resistance training trial in pancreatic cancer patients indicated clinically relevant improve- ments in QoL after 3 but not after 6 months. Given the severity of pancreatic cancer, exercise recommendations may already commence at surgery.

Identifiants

pubmed: 31431236
pii: arztebl.2019.0471
doi: 10.3238/arztebl.2019.0471
pmc: PMC6718894
doi:
pii:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

471-478

Références

Med Sci Sports Exerc. 2010 Jul;42(7):1409-26
pubmed: 20559064
J Cachexia Sarcopenia Muscle. 2017 Oct;8(5):778-788
pubmed: 28614627
J Cachexia Sarcopenia Muscle. 2018 Apr;9(2):326-334
pubmed: 29399990
Prev Med. 2017 Nov;104:124-132
pubmed: 28716654
J Am Coll Surg. 2012 Apr;214(4):463-75; discussion 475-7
pubmed: 22321518
J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
pubmed: 8433390
Pancreas. 2019 Feb;48(2):257-266
pubmed: 30589829
Support Care Cancer. 2010 Nov;18(11):1367-76
pubmed: 20502922
Med Sci Sports Exerc. 2016 May;48(5):767-75
pubmed: 26694846
Br J Surg. 2005 Apr;92(4):471-7
pubmed: 15672431
Therap Adv Gastroenterol. 2013 Jul;6(4):321-37
pubmed: 23814611
Psychol Methods. 2002 Mar;7(1):105-25
pubmed: 11928886
Mol Clin Oncol. 2016 Mar;4(3):315-325
pubmed: 26998283
Breast Cancer Res Treat. 2017 Apr;162(3):489-499
pubmed: 28181128
Cancers (Basel). 2017 May 20;9(5):null
pubmed: 28531109
Surgery. 2012 Sep;152(3 Suppl 1):S81-8
pubmed: 22770957
Pol Arch Intern Med. 2017 Jan 10;127(1):25-35
pubmed: 28075422
J Gastrointest Surg. 2008 May;12(5):783-93; discussion 793-4
pubmed: 18317851
Cochrane Database Syst Rev. 2012 Aug 15;(8):CD008465
pubmed: 22895974
Br J Surg. 2006 Sep;93(9):1099-107
pubmed: 16779883
Ann Surg Oncol. 2016 Jul;23(7):2137-45
pubmed: 26786091
Cancer Treat Rev. 2017 Jan;52:91-104
pubmed: 28006694

Auteurs

Karen Steindorf (K)

Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Germany

Dorothea Clauss (D)

Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Germany
Division of Medical Oncology, National Center for Tumor Diseases and Heidelberg University Hospital, Heidelberg, Germany

Christine Tjaden (C)

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, German

Thilo Hackert (T)

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, German

Florian Herbolsheimer (F)

Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Germany

Thomas Bruckner (T)

Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany

Lutz Schneider (L)

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, German

Cornelia M Ulrich (CM)

Department of Population Health Sciences, Huntsman Cancer Institute and University of Utah, Salt Lake City, USA

Joachim Wiskemann (J)

Division of Medical Oncology, National Center for Tumor Diseases and Heidelberg University Hospital, Heidelberg, Germany

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH