Abstract
Purpose
While there is growing evidence for positive effects of progressive resistance training in curatively treated cancer patients, data on advanced cancer patients are scarce. This pilot study aimed at investigating for the first time feasibility and effects of progressive resistance training in advanced cancer patients undergoing tyrosine kinase inhibitor (TKI) therapy.
Methods
Patients starting a TKI-based anti-tumor therapy were assigned to a resistance training group (RT, 12 weeks of progressive machine-based resistance training 2×/week) or a control group (CON, treatment as usual) until 10 patients had finished in each group (RT 80% males, 90% renal cell carcinoma, 65 ± 11 years, CON 80% males, 70% renal cell carcinoma, 61 ± 6 years). Primary endpoint was feasibility. Furthermore, fatigue (MFI), quality of life (QoL, EORTC QLQC30), and muscle strength were assessed. Testing occurred at baseline and after 12 weeks.
Results
Training was feasible in 9 out of 10 participants and no serious adverse events occurred. It had beneficial effects on muscle strength (maximum voluntary isometric contraction of the quadriceps: RT +11 ± 9 Nm, CON −13 ± 25 Nm, p = 0.005), but not on fatigue (general fatigue score RT +0.3 ± 4.1, CON -1.5 ± 3.0, p = 0.223) or QoL (global QoL score RT −5.6 ± 16.1, CON −2.0 ± 18.2, p = 0.617).
Conclusions
Progressive machine-based resistance training appears feasible in the majority of advanced cancer patients undergoing TKI therapy. However, its positive effects on muscle strength do not seem to be associated with positive effects on fatigue or quality of life. Future studies should therefore compare whether home-based training is more beneficial for patient-reported outcomes.
Trial registration
NCT01645150
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Notes
Compared to the clinical trials protocol, fatigue was downgraded from primary to secondary endpoint due to the small sample size/weak statistical power.
Two training logs were incomplete.
Three patients handed in incomplete questionnaires at 12 weeks, resulting in varying numbers of participants for each outcome.
One test was performed without gas exchange measurements due to technical problems, and in one case, VT was indeterminate.
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Acknowledgements
We thank Professor Karen Steindorf, Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany, for the helpful discussions on study design and conduct and the continuous support with important resources including the diagnostic lab facilities.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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F. Rosenberger and J. Wiskemann shared first authorship
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Rosenberger, F., Wiskemann, J., Vallet, S. et al. Resistance training as supportive measure in advanced cancer patients undergoing TKI therapy—a controlled feasibility trial. Support Care Cancer 25, 3655–3664 (2017). https://doi.org/10.1007/s00520-017-3788-3
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DOI: https://doi.org/10.1007/s00520-017-3788-3