The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer

Abstract

We retrospectively analysed acute radiation toxicity data for patients who had participated in a randomised controlled study in our centre in order to assess the impact of aerobic exercise on acute rectal and bladder morbidity during treatment. Data from 65 of 66 patients were analysed: 33 allocated into a control group (standard advice) and 33 into an exercise group (aerobic walking for 30 min at least three times per week) during 4 weeks of external beam radiotherapy; one patient in the exercise group withdrew after randomisation before starting radiotherapy. There was a trend towards less severe acute rectal toxicity in the exercise group with a statistically significant difference in mean toxicity scores over the 4 weeks of radiotherapy (P=0.004), with no significant difference in bladder toxicity scores between the two groups (P=0.123). The lack of an association for severity of bladder toxicity could be attributed to the confounding effect of lower urinary tract symptoms from their prostate cancer. Keeping active and being asked to adhere to a well-defined exercise schedule appears to reduce the severity of rectal toxicity during radiotherapy to the prostate.

Clinical exercise interventions in prostate cancer patients—a systematic review of randomized controlled trials

“…Similar results could be observed in prostate cancer patients performing aerobic endurance training during irradiation [27][28][29]. In addition to that, toxicity scores decreased [30]. However, resistance training brings about more positive effects than endurance training [27].…”

“…Primarily, physiological and psychological parameters were assessed (see "Methods" Section). While the studies that observed patients during irradiation or ADT chose an aerobic endurance and/or resistance training program [27][28][29][30][31][32][33], the remaining 14 studies examined the effects of a pelvic floor and sphincter training in inpatients pre-and/or post-op [34][35][36][37][38][39][40][41][42][43][44][45][46][47].…”

“…Therefore, these studies were rated evidence level "1b" [27,29,31,34,44]. The remaining 16 studies lack this information and therefore had to be downgraded to the level "2b" [28,30,32,33,[35][36][37][38][39][40][41][42][43][45][46][47].…”

Exercise Preferences Among Men With Prostate Cancer Receiving Androgen-Deprivation Therapy

“…Current research protocols have been designed to evaluate the impact of exercise on parameters adversely affected by ADT (e.g., aerobic and resistance modalities; delivery, whether home, clinic, or community gym; duration of program) (Culos-Reed, Robinson, Lau, O'Connor, & Keats, 2007;Galvão et al, 2006Galvão et al, , 2008Galvão, Taaffe, Spry, Joseph, & Newton, 2010;Kapur, Windsor, & McCowan, 2010;Mustian et al, 2009;Schneider, Hsieh, Sprod, Carter, & Hayward, 2007;Segal et al, 2009). The studies, however, were designed without any consideration for patient preferences, which affect recruitment, adherence, attrition, and, thus, outcomes, as well as external and internal validity of the study (Preference Collaborative Review Group, 2008;Swift & Callahan, 2009).…”

Clinical observation on the efficacy of CyberKnife for primary or metastatic retroperitoneal tumours

“…These various types of pathologies require different levels of fractionation. Many of these pathologies are also resistant to radiation and thus require a high dose to the targeted area (Tsumura et al 1996;Shinoto et al 2006;Yavuzcan et al 2009;Kapur et al 2010). Second, the retroperitoneum has a complex anatomy (Nishino et al 2003;Khalifa et al 2009).…”