Pilot, randomized trial of resistance exercise during radiation therapy for head and neck cancer

Rogers, Laura Q.; Anton, Philip M.; Fogleman, Amanda; Hopkins-Price, Patricia; Verhulst, Steven J.; Rao, Krishna; Malone, James P.; Robbs, Randy; Courneya, Kerry S.; Nanavati, Parashar J.; Mansfield, Sara A.; Robbins, K. Thomas

doi:10.1002/hed.23118

Cited by 74 publications

(173 citation statements)

References 77 publications

(33 reference statements)

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“…Of the sixteen studies involving patients in active treatment [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] , six demonstrated that, compared with the control group, the intervention group experienced significant improvements in qol 30,31,33,[38][39][40]43 . In the thirteen post-treatment intervention studies 10,12,14,[45][46][47][48][49][50][51][52][53][54] , two reported similar significant differences between groups 46,49 .…”

Section: Quality Of Lifementioning

confidence: 99%

Exercise for People with Cancer: A Clinical Practice Guideline

et al. 2017

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Background Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario’s Program in Evidence-Based Care (pebc). The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer, focusing on the benefits of specific types of exercise, recommendations about screening requirements for new referrals, and safety concerns.Methods Consistent with the pebc’s standardized approach, a systematic search was conducted for existing guidelines, and systematic literature searches were performed in medline and embase for both systematic reviews and primary literature. Content and methodology experts performed an internal review, which was followed by an external review by targeted experts and intended users.Results The search identified three guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present guideline provides recommendations for the duration, frequency, and intensity of exercise appropriate for people living with cancer. It also provides recommendations for pre-exercise assessment, safety concerns, and delivery models.Conclusions There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm. The present guideline is intended to support the Canadian Society for Exercise Physiology’s Canadian physical activity guidelines. The recommendations are intended for clinicians and institutions treating cancer patients in Ontario, and for policymakers and program planners involved in the delivery of exercise programs for cancer patients.

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Section: Quality Of Lifementioning

confidence: 99%

Exercise for People with Cancer: A Clinical Practice Guideline

et al. 2017

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“…There was considerable heterogeneity in the study methodology, differing in the type and timing of exercise intervention, as well as the outcomes measured. Regardless, it is clear from the control arms, when available, that there is a negative impact of no intervention [59,60]. Much like the limitations of current literature in nutritional interventions for HNSCC, there is a need to standardize research in exercise interventions including the type, timing, frequency and duration of studied regimens.…”

Section: Main Textmentioning

confidence: 99%

A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

2016

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Background: Concurrent chemotherapy and radiation (CTRT) improves disease-free survival in locally advanced head and neck cancer but is associated with numerous acute and chronic toxicities resulting in substantial alterations in body mass and composition. We aim to summarize the current evidence on body composition changes experienced by patients undergoing CTRT, examine the impact of these changes on clinical outcomes and address potential interventions aimed at mitigating the loss. Main Body: Loss of 20 % of pre-CTRT weight predicts poorer treatment tolerance and 30-day mortality. While clinical practice focuses on body weight, emerging data indicates that CTRT causes profound adverse changes in lean body mass (sarcopenia). Higher prevalence of sarcopenia predicts poorer disease-free survival as well as overall survival, lower quality of life and functional performance. The magnitude of CTRT-induced sarcopenia is the equivalent to that observed in a decade of aging in a healthy adult. Alterations in body composition are only explained, in part, by decreased caloric intake; other significant predictors include body mass index, stage, and dysphagia. Lifestyle interventions aimed at preventing loss of whole-body and especially lean mass include nutritional counseling, nutritional supplements, dietary supplements and exercise training. Personalized nutritional counseling has been associated with improvement in quality of life, while the benefits of feeding tube placement are inconsistent. There are inconsistently reported benefits of resistance training in this population. Conclusion: Patients with head and neck cancer undergoing CTRT therapy experience dramatic shifts in body composition, including sarcopenia, which can negatively impact clinical outcomes. Efforts to understand the magnitude, clinical importance and mechanisms of sarcopenia are needed to inform a more personalized approach to mitigating the body composition changes associated with CTRT.

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“…Fourteen systematic reviews [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] found an improvement in qol for people with cancer participating in an exercise intervention during the active treatment or post-treatment periods (Table v). Of the sixteen rcts involving patients in active treatment [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] , seven reported significant differences between the intervention and control groups (Table vi) 23,24,26,[31][32][33]36 . In the thirteen posttreatment intervention studies [38][39][40][41][42][43][44]…”

Section: Qol and Muscular And Aerobic Fitnessmentioning

confidence: 99%

“…One systematic review 20 found that cardiopulmonary exercise testing was a safe, noninvasive method to measure cardiopulmonary fitness in people living with cancer, both during and after treatment. Seventeen rcts [22][23][24]27,29,[30][31][32][33]37,39,42,45,47,[51][52][53] found that no adverse events or side effects were attributable to the exercise program. Seven 26,28,34,35,40,46,50 did not report on adverse events at all.…”

Section: Commentsmentioning

confidence: 99%

Exercise for people with cancer: a systematic review

et al. 2017

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Background This systematic review was completed by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario’s Program in Evidence-Based Care (pebc). It provides background and guidance for clinicians with respect to exercise for people living with cancer in active and post treatment. It focuses on the benefits of specific types of exercise, pre-screening requirements for new referrals, safety concerns, and delivery models.Methods Using the pebc’s standardized approach, medline and embase were systematically searched for existing guidelines, systematic reviews, and primary literature.Results The search identified two guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present review provides conclusions about the duration, frequency, and intensity of exercise appropriate for people living with cancer.Conclusions The evidence shows that exercise is safe and provides benefit in quality of life and in muscular and aerobic fitness for people with cancer both during and after treatment. The evidence is sufficient to support the promotion of exercise for adults with cancer, and some evidence supports the promotion of exercise in group or supervised settings and for a long period of time to improve quality of life and muscular and aerobic fitness. Exercise at moderate intensities could also be sustainable for longer periods and could encourage exercise to be continued over an individual’s lifetime. It is important that a pre-screening assessment be conducted to evaluate the effects of disease, treatments, and comorbidities.

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Pilot, randomized trial of resistance exercise during radiation therapy for head and neck cancer

Abstract: Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation; a definitive trial is warranted.

Cited by 74 publications

References 77 publications

Exercise for People with Cancer: A Clinical Practice Guideline

Exercise for People with Cancer: A Clinical Practice Guideline

A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

Exercise for people with cancer: a systematic review

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