Radiotherapy before or during androgen-deprivation therapy does not blunt the exercise-induced body composition protective effects in prostate cancer patients: A secondary analysis of two randomized controlled trials.


Journal

Experimental gerontology
ISSN: 1873-6815
Titre abrégé: Exp Gerontol
Pays: England
ID NLM: 0047061

Informations de publication

Date de publication:
08 2021
Historique:
received: 26 02 2021
revised: 07 05 2021
accepted: 25 05 2021
pubmed: 31 5 2021
medline: 3 7 2021
entrez: 30 5 2021
Statut: ppublish

Résumé

Androgen deprivation therapy (ADT) contributes to lean mass loss and adiposity increases in prostate cancer patients. Radiotherapy during ADT might act synergistically and further worsen body composition. Previous investigations have shown that resistance training is an effective method of preserving body composition during ADT, however, most have not accounted for direct or indirect effects of other therapies, such as radiotherapy. Therefore, the purpose of this study was to examine training adaptations of the tissue composition in patients receiving radiation therapy (RT) prior or during ADT. Analyses were performed by combining data from two previous trials for a total of 131 prostate cancer patients who underwent a combination of resistance and aerobic exercise training (N = 70, age: 68.9 ± 6.6y, RT-before: 13%, RT-during: 14%) or usual care (N = 61, age: 67.5 ± 7.9y, RT-before: 16%, RT-during: 20%) for 3 months upon ADT onset. Whole-body lean mass (LM), fat percentage and appendicular LM were determined by dual energy x-ray absorptiometry, and lower-leg muscle area and density by peripheral computed tomography at baseline (onset of ADT) and at 3 months post-intervention. Covariates included RT prior and during the intervention, demographic characteristics, physical symptoms, and chronic conditions. Radiotherapy before or during the intervention did not affect body composition. Only the usual care group experienced a significant decrease in whole-body LM (-994 ± 150 g, P < 0.001) and appendicular LM (-126 ± 19 g, P < 0.001), and an increase in whole-body fat percentage (1% ± 0.1%, P < 0.001). There was no change in lower-leg muscle area or density in either group. We suggest that radiation prior to and during ADT does not interfere with the beneficial effects of exercise training on body composition in men with prostate cancer.

Sections du résumé

BACKGROUND
Androgen deprivation therapy (ADT) contributes to lean mass loss and adiposity increases in prostate cancer patients. Radiotherapy during ADT might act synergistically and further worsen body composition. Previous investigations have shown that resistance training is an effective method of preserving body composition during ADT, however, most have not accounted for direct or indirect effects of other therapies, such as radiotherapy. Therefore, the purpose of this study was to examine training adaptations of the tissue composition in patients receiving radiation therapy (RT) prior or during ADT.
METHODS
Analyses were performed by combining data from two previous trials for a total of 131 prostate cancer patients who underwent a combination of resistance and aerobic exercise training (N = 70, age: 68.9 ± 6.6y, RT-before: 13%, RT-during: 14%) or usual care (N = 61, age: 67.5 ± 7.9y, RT-before: 16%, RT-during: 20%) for 3 months upon ADT onset. Whole-body lean mass (LM), fat percentage and appendicular LM were determined by dual energy x-ray absorptiometry, and lower-leg muscle area and density by peripheral computed tomography at baseline (onset of ADT) and at 3 months post-intervention. Covariates included RT prior and during the intervention, demographic characteristics, physical symptoms, and chronic conditions.
RESULTS
Radiotherapy before or during the intervention did not affect body composition. Only the usual care group experienced a significant decrease in whole-body LM (-994 ± 150 g, P < 0.001) and appendicular LM (-126 ± 19 g, P < 0.001), and an increase in whole-body fat percentage (1% ± 0.1%, P < 0.001). There was no change in lower-leg muscle area or density in either group.
CONCLUSION
We suggest that radiation prior to and during ADT does not interfere with the beneficial effects of exercise training on body composition in men with prostate cancer.

Identifiants

pubmed: 34052346
pii: S0531-5565(21)00209-6
doi: 10.1016/j.exger.2021.111427
pii:
doi:

Substances chimiques

Androgen Antagonists 0
Androgens 0

Banques de données

ANZCTR
['ACTRN12612000097842', 'ACTRN12610000691044']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

111427

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Robert U Newton (RU)

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia. Electronic address: r.newton@ecu.edu.au.

Georgios Mavropalias (G)

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.

Maren S Fragala (MS)

Quest Diagnostics, Secaucus, NJ, USA.

William J Kraemer (WJ)

Department of Human Sciences, The Ohio State University, Columbus, OH, USA.

Keijo Häkkinen (K)

Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

Dennis R Taaffe (DR)

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.

Nigel Spry (N)

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.

David Joseph (D)

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.

Daniel A Galvão (DA)

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.

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