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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2018

01-02-2018 | Original Article

Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial

Authors: Philipp Zimmer, Sina Trebing, Ursula Timmers-Trebing, Alexander Schenk, Rainer Paust, Wilhelm Bloch, Roland Rudolph, Fiona Streckmann, Freerk T. Baumann

Published in: Supportive Care in Cancer | Issue 2/2018

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Abstract

Purposes

Physical activity is supposed to decrease mortality of colorectal cancer (CRC) and is suggested to reduce side-effects of the disease and its treatment. However, the knowledge about the influence of exercise interventions on patients suffering from CRC and metastasized CRC (mCRC) is still sparse. One frequently observed side effect in mCRC is chemotherapy-induced peripheral neuropathy (CIPN). This randomized controlled trial investigated the influence of a supervised exercise program on CIPN in mCRC.

Methods

Thirty patients (stage IV) undergoing outpatient palliative treatment including a median of 23.5 chemotherapy cycles of various regimens were randomly assigned to an intervention or control group (IG, n = 17; CG, n = 13). The IG participated in an eight-week supervised exercise program, including endurance, resistance and balance training (2×/week for 60 min) whereas the CG received written standard recommendations to obtain physical fitness. CIPN was assessed using the FACT/GOG-NTX questionnaire. Moreover, endurance capacity (6MWT), strength (h1RM) and balance (GGT-Reha) were evaluated before (t 0) and after (t 1) the intervention as well as after 4 weeks follow-up (t2).

Results

Neuropathic symptoms remained stable in the IG over time, while CIPN significantly worsened in the CG from t 0 to t 1 and t 0 to t 2. In contrast to the CG, the IG significantly improved in strength and balance function. Changes in CIPN correlated with changes in balance.

Conclusions

This is the first investigation showing positive effects of a multimodal exercise program on CIPN, balance and strength on mCRC patients in a palliative setting, thereby consequently increasing patients` quality of life. The results support earlier findings stating a positive influence of balance exercise on CIPN.
Literature
1.
2.
Knopf K, Iqbal SU, Thompson SF, Malangone E, Gorritz-Kindu M, Stern L, Sherman SA, Naoshy S, Wooten M, Andria ML (2013) Survival outcomes in U.S. patients with metastatic colorectal cancer: a retrospective database analysis. J Clin Oncol 31(suppl 4; abstr 559)
3.
Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV (2013) Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol 31(21):2699–2707CrossRefPubMed
4.
Campos MP, Hassan BJ, Riechelmann R, Del Giglio A (2011) Cancer-related fatigue: a practical review. Ann Oncol 22(6):1273–1279CrossRefPubMed
5.
Leitzmann M, Powers H, Anderson AS, Scoccianti C, Berrino F, Boutron-Ruault MC, Cecchini M, Espina C, Key TJ, Norat T, Wiseman M, Romieu I (2015) European code against cancer 4th edition: physical activity and cancer. Cancer Epidemiol 39(suppl 1):S46–S55CrossRefPubMed
6.
Je Y, Jeon JY, Giovannucci EL, Meyerhardt JA (2013) Association between physical activity and mortality in colorectal cancer: a meta-analysis of prospective cohort studies. Int J Cancer 133(8):1905–1913CrossRefPubMed
7.
Tomlinson D, Diorio C, Beyene J, Sung L (2014) Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil 93(8):675–686CrossRefPubMed
8.
Schmidt ME, Wiskemann J, Armbrust P, Schneeweiss A, Ulrich CM, Steindorf K (2015) Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer 137(2):471–480CrossRefPubMed
9.
Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L, Bryan CJ, Williams-Smith CT, Greene QP (2009) Weight lifting in women with breast-cancer–related lymphedema. N Engl J Med 361:664–673CrossRefPubMed
10.
11.
Gerritsen JK, Vincent AJ (2016) Exercise improves quality of life in patients with cancer: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 50(13):796–803CrossRefPubMed
12.
Oldervoll LM, Loge JH, Paltiel H, Asp MB, Vidvei U, Wiken AN, Hjermstad MJ, Kaasa S (2006) The effect of a physical exercise program in palliative care: a phase II study. J Pain Symptom Manag 31(5):421–430CrossRef
13.
Jensen W, Baumann FT, Stein A, Bloch W, Bokemeyer C, de Wit M, Oechsle K (2014) Exercise training in patients with advanced gastrointestinal cancer undergoing palliative chemotherapy: a pilot study. Support Care Cancer 22(7):1797–1806PubMed
14.
Basen-Engquist K, Parker PA, Eng C, Li Y, Johnson DB, Kee BK, Thomas SS, Wong L, Crocenzi TS, Song J, Fisch M (2015) Randomized trial of a home-based exercise intervention for patients with advanced colorectal cancer: effects on physical functioning and activity levels. J Clin Oncol 33(suppl; abstract 9633)
15.
Cheville AL, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G, Basford JR (2013) A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manag 45(5):811–821CrossRef
16.
Stubblefield MD, Burstein HJ, Burton AW, Custodio CM, Deng GE, Ho M, Junck L, Morris GS, Paice JA, Tummala S, Von Roenn JH (2009) NCCN task force report: management of neuropathy in cancer. J Natl Compr Cancer Netw 7(suppl 5):S1–S26CrossRef
17.
Areti A, Yerra VG, Naidu V, Kumar A (2014) Oxidative stress and nerve damage: role in chemotherapy induced peripheral neuropathy. Redox Biol 2:289–295CrossRefPubMedPubMedCentral
18.
19.
Pachman DR, Qin R, Seisler DK, Smith EM, Beutler AS, Ta LE, Lafky JM, Wagner-Johnston ND, Ruddy KJ, Dakhil S, Staff NP, Grothey A, Loprinzi CL (2015) Clinical course of oxaliplatin-induced neuropathy: results from the randomized phase III trial N08CB (alliance). J Clin Oncol 33(30):3416–3422CrossRefPubMedPubMedCentral
20.
Herman HK, Monfort SM, Pan XJ, Chaudhari AMW, Lustberg MB (2017) Effects of chemotherapy-induced peripheral neuropathy on postural control in cancer survivors. J Clin Oncol 35(suppl 5S; abstr 128)
21.
Kaley TJ, Deangelis LM (2009) Therapy of chemotherapy-induced peripheral neuropathy. Br J Haematol 145(1):3–14CrossRefPubMed
22.
Wonders KY, Reigle BS, Drury DG (2010) Treatment strategies for chemotherapy-induced peripheral neuropathy: potential role of exercise. Oncol Rev 4(2):117–125CrossRef
23.
Brami C, Bao T, Deng G (2016) Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review. Crit Rev Oncol Hematol 98:325–334CrossRefPubMed
24.
25.
Streckmann F, Kneis S, Leifert JA, Baumann FT, Kleber M, Ihorst G, Herich L, Grüssinger V, Gollhofer A, Bertz H (2014) Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol 25(2):493–499CrossRefPubMed
26.
Henke CC, Cabri J, Fricke L, Pankow W, Kandilakis G, Feyer PC, de Wit M (2014) Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV. Support Care Cancer 22(1):95–101CrossRefPubMed
27.
Streckmann F, Zopf EM, Lehmann HC, May K, Rizza J, Zimmer P, Gollhofer A, Bloch W, Baumann FT (2014) Exercise intervention studies in patients with peripheral neuropathy: a systematic review. Sports Med 44(9):1289–1304CrossRefPubMed
28.
29.
30.
Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, Bressler LR, Fadul CE, Knox C, Le-Lindqwister N, Gilman PB, Shapiro CL (2013) Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. JAMA 309(13):1359–1367CrossRefPubMedPubMedCentral
31.
Land SR, Kopec JA, Cecchini RS, Ganz PA, Wieand HS, Colangelo LH, Murphy K, Kuebler JP, Seay TE, Needles BM, Bearden JD 3rd, Colman LK, Lanier KS, Pajon ER Jr, Cella D, Smith RE, O'Connell MJ, Costantino JP, Wolmark N (2007) Neurotoxicity from oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: NSABP C-07. J Clin Oncol 25(16):2205–2211CrossRefPubMed
32.
Theisen D, Wydra G (2011) Untersuchung der Gleichgewichtsfähigkeit. Bewegungstherapie und Gesundheitssport (B & G) 27(6):231–239CrossRef
33.
LeSuer DA, McCormick JH, Mayhew J, Wasserstein RL, Arnold MD (1997) The accuracy of prediction equations for estimating 1-RM performance in the bench press, squat, and deadlift. J Strength Cond Res 11(4):211–213
34.
Gießing J (2003) Trainingsplanung und -steuerung beim Muskelaufbautraining. Das Konzept vom individuellen hypothetischen Maximalgewicht (h1RM) als methodische Alternative. Leistungssport 33(4):26–31
35.
Baumann FT (2008) Krafttraining mit Krebspatienten. In: Baumann FT, Schüle K (eds) Bewegungstherapie und Sport bei Krebs: Leitfaden für die Praxis. Deutscher Ärzte-Verlag, Cologne, pp 65–66
36.
American Thoracic Society Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS statement : guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1):111–117CrossRef
37.
38.
Beijers AJ, Mols F, Tjan-Heijnen VC, Faber CG, van de Poll-Franse LV, Vreugdenhil G (2015) Peripheral neuropathy in colorectal cancer survivors: the influence of oxaliplatin administration. Results from the population-based PROFILES registry. Acta Oncol 54(4):463–469CrossRefPubMed
39.
40.
Blauwhoff-Buskermolen S, Versteeg KS, de van der Schueren MA, den Braver NR, Berkhof J, Langius JA, Verheul HM (2016) Loss of muscle mass during chemotherapy is predictive for poor survival of patients with metastatic colorectal cancer. J Clin Oncol 34(12):1339–1344CrossRefPubMed
41.
Troosters T, Gosselink R, Decramer M (1999) Six minute walk distance in healthy elderly subjects. Eur Respir J 14(2):270–274CrossRefPubMed
42.
Jensen W, Oechsle K (2014) Bewegungstherapie bei Krebspatienten in palliativer Erkrankungssituation – ein Überblick. Bewegungstherapie und Gesundheitssport (B&G) 30:162–166CrossRef
Metadata
Title
Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial
Authors
Philipp Zimmer
Sina Trebing
Ursula Timmers-Trebing
Alexander Schenk
Rainer Paust
Wilhelm Bloch
Roland Rudolph
Fiona Streckmann
Freerk T. Baumann
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3875-5

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