EXCAP exercise to improve fatigue, cardiopulmonary function, and strength: A phase II RCT among older prostate cancer patients receiving radiation and androgen deprivation therapy.

Abstract

9010 Background: Radiation therapy (RT) and androgen deprivation therapy (ADT) result in cancer-related fatigue (CRF), decreased cardiopulmonary function (CPF) and decreased strength. Research suggests exercise can improve CRF during RT and ADT, through physical conditioning responses that improve CPF and strength. We explored the influence of an individually-tailored, home-based exercise intervention (EXCAP), including progressive resistance and aerobic training, on CRF, CPF and strength. Methods: Older prostate cancer patients (N=58; mean age=67), receiving RT (47%) or ADT (53%), were randomized to 6 wks of EXCAP (7 days/wk) or standard care (RT or ADT with no exercise). CPF (VO2 max) was assessed via graded exercise testing (GXT) or a 6-minute walk test when GXT was contraindicated. Muscular strength was assessed using multiple repetition maximum testing (chest press and leg extension). CRF was assessed via valid self-report questionnaires (BFI, POMS-FI, MFSI). All assessments were pre- and post-intervention. Results: ANCOVAs, controlling for baseline, revealed significant differences between groups in mean levels of CRF on the BFI and POMS-FI (all p<0.05), and a trend toward differences on the MFSI (p<0.10) with significant baseline interactions (all p<0.05) post-intervention: exercisers decreased CRF while controls increased. ANCOVAs revealed a trend toward differences between groups in mean levels of CPF (VO2 max) and strength (all p<0.10): exercisers improved while controls declined in performance. Pearson correlations revealed significant inverse associations between changes in CRF (BFI) and CPF (p<0.05;r=-0.0.36), and CRF and strength (p<0.05;r=-0.0.31). MANOVA revealed that changes in CPF and strength significantly predicted changes in CRF (p<0.05, r=0.67) and accounted for 45% of the variance. Conclusions: Exercise improves CRF and these improvements may be mediated, in part, by improvements in CPF and strength. Future phase III RCTs with prostate cancer patients receiving RT and ADT are needed to confirm these relationships. Funding: DOD W81XWH-07-1-0341, NCI K07CA120025, NCI 1R25CA102618.