Effect of Exercise Adjunct to Radiation and Androgen Deprivation Therapy on Patient-Reported Treatment Toxicity in Men With Prostate Cancer: A Secondary Analysis of 2 Randomized Controlled Trials

Abstract

Physical inactivity, in addition to clinical factors, has been associated with higher levels of late pelvic symptoms in patients with prostate cancer (PCa) after radiation therapy. The aim of this study was to investigate the effect of a structured multicomponent exercise program comprised of aerobic and resistance training as well as impact loading on the prevalence and severity of symptoms commonly resulting from androgen deprivation therapy (ADT) and pelvic radiation therapy. Methods and Materials: We performed a secondary analysis of pooled data from 2 randomized controlled trials that investigated the role of exercise on treatment-related side effects in patients with PCa receiving ADT. Patients were included in the analysis if they had undergone radiation therapy during the intervention in addition to ADT. Patient-reported quality of life and functional and symptom scales were assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and PR25 before and after 6 months of exercise or usual care (UC).

Effects of Exercise During Radiation Therapy on Physical Function and Treatment-Related Side Effects in Men With Prostate Cancer: A Systematic Review and Meta-Analysis

“…This finding is in line with observational data showing that more physical activity was positively associated with better sexual function [53], including active men having better erectile function than inactive men [41]. However, recent contrasting reports indicate that a structured exercise program had no significant beneficial effect on sexual function in men with prostate cancer undergoing treatment [54,55], although exercise resulted in maintenance of sexual activity levels [56].…”

Do Patients with Prostate Cancer Benefit from Exercise Interventions? A Systematic Review and Meta-Analysis

“…Of the 6693 identified records, 33 trials (2567 participants) were found to be eligible for inclusion in this systematic review [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. We identified 24 linked publications with follow-up measurements or secondary analyses [ 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75...…”

Supervised exercise therapy compared with no exercise therapy to reverse debilitating effects of androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis

“…The update of this search (June 2021) identified another 871 records, of which 109 were assessed by full-text review and 10 RCTs were included. In total 18 RCTs (25 publications) were included [ 17 – 22 , 27 – 31 , 45 – 58 ]. See PRISMA flow charts for the trial selection process in Supplementary Figure S1 , S2 .…”

“…The interventions comprised supervised exercise therapy with moderate to high intensity between 60–90% of 1 RM (repetition maximum) for resistance exercise and between 55–85% of the estimated maximum heart rate for aerobic exercise. The majority of the exercise programs were progressive in nature [ 17 – 22 , 27 – 31 , 45 – 48 , 50 , 52 – 58 ].…”

“…All included trials were assessed to have high risk of performance bias due to lack of blinding of participants and personnel, since blinding for the intervention was not feasible. Thirteen trials [ 17 , 18 , 21 , 22 , 27 , 29 , 30 , 45 – 50 , 52 , 54 , 57 , 58 ] had high risk of detection bias, since the critical outcome ‘disease-specific quality of life’ was self-reported and participants not blinded. Three trials had unclear risk of attrition bias (incomplete outcome data) [ 17 , 49 , 51 ].…”