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Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Study protocol

Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy

Authors: Y. Wengström, K. A. Bolam, S. Mijwel, C. J. Sundberg, M. Backman, M. Browall, J. Norrbom, H. Rundqvist

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy. The second aim is to examine if any effects are sustained 1, 2, and 5 years following the completion of the intervention and to monitor return to work, recurrence and survival. The third aim of the study is to examine the effect of attendance and adherence rates on the effects of the exercise programme.

Methods

This study is a randomised controlled trial including 240 women with breast cancer receiving chemotherapy in Stockholm, Sweden. The participants are randomly allocated to either: group 1: Aerobic training, group 2: Combined resistance and aerobic training, or group 3: usual care (control group). During the 5-year follow-up period, participants in the exercise groups will receive a physical activity prescription. Measurements for endpoints will take place at baseline, after 16 weeks (end of intervention) as well as after 1, 2 and 5 years.

Discussion

This randomised controlled trial will generate substantial information regarding the effects of different types of exercise on the health of patients with breast cancer undergoing chemotherapy. We expect that dissemination of the knowledge gained from this study will contribute to developing effective long term strategies to improve the physical and psychosocial health of breast cancer survivors.

Trial registration

OptiTrain - Optimal Training Women with Breast Cancer (OptiTrain), NCT02522260; Registration: June 9, 2015, Last updated version Feb 29, 2016. Retrospectively registered.
Literature
1.
go back to reference Newton RU, Galvao DA. Exercise in prevention and management of cancer. Curr Treat Options Oncol. 2008;9(2–3):135–46.CrossRefPubMed Newton RU, Galvao DA. Exercise in prevention and management of cancer. Curr Treat Options Oncol. 2008;9(2–3):135–46.CrossRefPubMed
2.
go back to reference Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, et al. Cancer-related fatigue, version 2.2015. J Nat Compr Canc Netw. 2015;13(8):1012–39. Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, et al. Cancer-related fatigue, version 2.2015. J Nat Compr Canc Netw. 2015;13(8):1012–39.
3.
go back to reference LaVoy EC, Fagundes CP, Dantzer R. Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev. 2016;22:82–93.PubMedPubMedCentral LaVoy EC, Fagundes CP, Dantzer R. Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev. 2016;22:82–93.PubMedPubMedCentral
4.
go back to reference Velthuis MJ, Agasi-Idenburg SC, Aufdemkampe G, Wittink HM. The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. J Clin Oncol. 2010;22(3):208–21.CrossRef Velthuis MJ, Agasi-Idenburg SC, Aufdemkampe G, Wittink HM. The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. J Clin Oncol. 2010;22(3):208–21.CrossRef
5.
go back to reference Schmidt ME, Wiskemann J, Armbrust P, Schneeweiss A, Ulrich CM, Steindorf K. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer. 2015;137(2):471–80.CrossRefPubMed Schmidt ME, Wiskemann J, Armbrust P, Schneeweiss A, Ulrich CM, Steindorf K. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer. 2015;137(2):471–80.CrossRefPubMed
6.
go back to reference Meneses-Echavez JF, Gonzalez-Jimenez E, Ramirez-Velez R. Effects of supervised multimodal exercise interventions on cancer-related fatigue: systematic review and meta-analysis of randomized controlled trials. BioMed Res Int. 2015;2015:328636.CrossRefPubMedPubMedCentral Meneses-Echavez JF, Gonzalez-Jimenez E, Ramirez-Velez R. Effects of supervised multimodal exercise interventions on cancer-related fatigue: systematic review and meta-analysis of randomized controlled trials. BioMed Res Int. 2015;2015:328636.CrossRefPubMedPubMedCentral
7.
go back to reference Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev (Online). 2012;8:CD007566. Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev (Online). 2012;8:CD007566.
8.
go back to reference Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.CrossRefPubMedPubMedCentral Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.CrossRefPubMedPubMedCentral
9.
go back to reference Hartvig P, Aulin J, Wallenberg S, Wagenius G. Physical exercise for cytotoxic drug-induced fatigue. J Oncol Pharm Pract. 2006;12(4):183–91.CrossRefPubMed Hartvig P, Aulin J, Wallenberg S, Wagenius G. Physical exercise for cytotoxic drug-induced fatigue. J Oncol Pharm Pract. 2006;12(4):183–91.CrossRefPubMed
10.
go back to reference Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43.CrossRefPubMed Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43.CrossRefPubMed
11.
go back to reference Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32.CrossRefPubMedPubMedCentral Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32.CrossRefPubMedPubMedCentral
12.
go back to reference Cuzick J, Sestak I, Baum M, Buzdar A, Howell A, Dowsett M, Forbes JF. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol. 2010;11(12):1135–41.CrossRefPubMed Cuzick J, Sestak I, Baum M, Buzdar A, Howell A, Dowsett M, Forbes JF. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol. 2010;11(12):1135–41.CrossRefPubMed
13.
go back to reference Gilliam LA, St Clair DK. Chemotherapy-induced weakness and fatigue in skeletal muscle: the role of oxidative stress. Antioxid Redox Signal. 2011;15(9):2543–63.CrossRefPubMedPubMedCentral Gilliam LA, St Clair DK. Chemotherapy-induced weakness and fatigue in skeletal muscle: the role of oxidative stress. Antioxid Redox Signal. 2011;15(9):2543–63.CrossRefPubMedPubMedCentral
14.
go back to reference Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev. 2006;4:CD005001. Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev. 2006;4:CD005001.
15.
go back to reference Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.CrossRefPubMed Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.CrossRefPubMed
16.
go back to reference Jones LW, Alfano CM. Exercise-oncology research: past, present, and future. Acta Oncol. 2013;52(2):195–215.CrossRefPubMed Jones LW, Alfano CM. Exercise-oncology research: past, present, and future. Acta Oncol. 2013;52(2):195–215.CrossRefPubMed
17.
go back to reference Kiasuwa Mbengi R, Otter R, Mortelmans K, Arbyn M, Van Oyen H, Bouland C, de Brouwer C. Barriers and opportunities for return-to-work of cancer survivors: time for action-rapid review and expert consultation. Syst Rev. 2016;5(1):35.CrossRefPubMedPubMedCentral Kiasuwa Mbengi R, Otter R, Mortelmans K, Arbyn M, Van Oyen H, Bouland C, de Brouwer C. Barriers and opportunities for return-to-work of cancer survivors: time for action-rapid review and expert consultation. Syst Rev. 2016;5(1):35.CrossRefPubMedPubMedCentral
18.
go back to reference van Waart H, Stuiver MM, van Harten WH, Geleijn E, Kieffer JM, Buffart LM, de Maaker-Berkhof M, Boven E, Schrama J, Geenen MM, et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015;33(17):1918–27.CrossRefPubMed van Waart H, Stuiver MM, van Harten WH, Geleijn E, Kieffer JM, Buffart LM, de Maaker-Berkhof M, Boven E, Schrama J, Geenen MM, et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015;33(17):1918–27.CrossRefPubMed
19.
go back to reference Murphy EA, Enos RT, Velazquez KT. Influence of exercise on inflammation in cancer: direct effect or innocent bystander? Exerc Sport Sci Rev. 2015;43(3):134–42.CrossRefPubMed Murphy EA, Enos RT, Velazquez KT. Influence of exercise on inflammation in cancer: direct effect or innocent bystander? Exerc Sport Sci Rev. 2015;43(3):134–42.CrossRefPubMed
20.
go back to reference Hwang JE, Kim HN, Kim DE, Choi HJ, Jung SH, Shim HJ, Bae WK, Hwang EC, Cho SH, Chung IJ. Prognostic significance of a systemic inflammatory response in patients receiving first-line palliative chemotherapy for recurred or metastatic gastric cancer. BMC Cancer. 2011;11:489.CrossRefPubMedPubMedCentral Hwang JE, Kim HN, Kim DE, Choi HJ, Jung SH, Shim HJ, Bae WK, Hwang EC, Cho SH, Chung IJ. Prognostic significance of a systemic inflammatory response in patients receiving first-line palliative chemotherapy for recurred or metastatic gastric cancer. BMC Cancer. 2011;11:489.CrossRefPubMedPubMedCentral
21.
go back to reference Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11(9):607–15.CrossRefPubMed Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11(9):607–15.CrossRefPubMed
22.
go back to reference Strandberg E, Edholm P, Ponsot E, Wahlin-Larsson B, Hellmen E, Nilsson A, Engfeldt P, Cederholm T, Riserus U, Kadi F. Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial. J Appl Physiol (1985). 2015;119(8):918–25.CrossRef Strandberg E, Edholm P, Ponsot E, Wahlin-Larsson B, Hellmen E, Nilsson A, Engfeldt P, Cederholm T, Riserus U, Kadi F. Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial. J Appl Physiol (1985). 2015;119(8):918–25.CrossRef
23.
go back to reference Jones LW, Fels DR, West M, Allen JD, Broadwater G, Barry WT, Wilke LG, Masko E, Douglas PS, Dash RC, et al. Modulation of circulating angiogenic factors and tumor biology by aerobic training in breast cancer patients receiving neoadjuvant chemotherapy. Cancer Prev Res (Phila). 2013;6(9):925–37.CrossRef Jones LW, Fels DR, West M, Allen JD, Broadwater G, Barry WT, Wilke LG, Masko E, Douglas PS, Dash RC, et al. Modulation of circulating angiogenic factors and tumor biology by aerobic training in breast cancer patients receiving neoadjuvant chemotherapy. Cancer Prev Res (Phila). 2013;6(9):925–37.CrossRef
24.
go back to reference Glass OK, Inman BA, Broadwater G, Courneya KS, Mackey JR, Goruk S, Nelson ER, Jasper J, Field CJ, Bain JR, et al. Effect of aerobic training on the host systemic milieu in patients with solid tumours: an exploratory correlative study. Br J Cancer. 2015;112(5):825–31.CrossRefPubMedPubMedCentral Glass OK, Inman BA, Broadwater G, Courneya KS, Mackey JR, Goruk S, Nelson ER, Jasper J, Field CJ, Bain JR, et al. Effect of aerobic training on the host systemic milieu in patients with solid tumours: an exploratory correlative study. Br J Cancer. 2015;112(5):825–31.CrossRefPubMedPubMedCentral
25.
go back to reference Koelwyn GJ, Wennerberg E, Demaria S, Jones LW. Exercise in regulation of inflammation-immune axis function in cancer initiation and progression. Oncology (Williston Park). 2015;29(12):214800. Koelwyn GJ, Wennerberg E, Demaria S, Jones LW. Exercise in regulation of inflammation-immune axis function in cancer initiation and progression. Oncology (Williston Park). 2015;29(12):214800.
26.
go back to reference Piper BF. Piper fatigue scale available for clinical testing. Oncol Nurs Forum. 1990;17(5):661–2.PubMed Piper BF. Piper fatigue scale available for clinical testing. Oncol Nurs Forum. 1990;17(5):661–2.PubMed
27.
go back to reference Jakobsson S, Taft C, Ostlund U, Ahlberg K. Performance of the Swedish version of the revised Piper Fatigue Scale. Eur J Oncol Nurs. 2013;17(6):808–13.CrossRefPubMed Jakobsson S, Taft C, Ostlund U, Ahlberg K. Performance of the Swedish version of the revised Piper Fatigue Scale. Eur J Oncol Nurs. 2013;17(6):808–13.CrossRefPubMed
28.
go back to reference Bergstrom J. Percutaneous needle biopsy of skeletal muscle in physiological and clinical research. Scand J Clin Lab Invest. 1975;35(7):609–16.CrossRefPubMed Bergstrom J. Percutaneous needle biopsy of skeletal muscle in physiological and clinical research. Scand J Clin Lab Invest. 1975;35(7):609–16.CrossRefPubMed
29.
go back to reference Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer. 1994;30A(9):1326–36.CrossRefPubMed Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer. 1994;30A(9):1326–36.CrossRefPubMed
30.
go back to reference Browall M, Kenne Sarenmalm E, Nasic S, Wengstrom Y, Gaston-Johansson F. Validity and reliability of the Swedish version of the Memorial Symptom Assessment Scale (MSAS): an instrument for the evaluation of symptom prevalence, characteristics, and distress. J Pain Symptom Manage. 2013;46(1):131–41.CrossRefPubMed Browall M, Kenne Sarenmalm E, Nasic S, Wengstrom Y, Gaston-Johansson F. Validity and reliability of the Swedish version of the Memorial Symptom Assessment Scale (MSAS): an instrument for the evaluation of symptom prevalence, characteristics, and distress. J Pain Symptom Manage. 2013;46(1):131–41.CrossRefPubMed
31.
go back to reference Langius A, Bjorvell H, Antonovsky A. The sense of coherence concept and its relation to personality traits in Swedish samples. Scand J Caring Sci. 1992;6(3):165–71.CrossRefPubMed Langius A, Bjorvell H, Antonovsky A. The sense of coherence concept and its relation to personality traits in Swedish samples. Scand J Caring Sci. 1992;6(3):165–71.CrossRefPubMed
32.
33.
go back to reference Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.CrossRefPubMed Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.CrossRefPubMed
34.
35.
go back to reference Kallings LV, Leijon M, Hellenius ML, Stahle A. Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life. Scand J Med Sci Sports. 2008;18(2):154–61.CrossRefPubMed Kallings LV, Leijon M, Hellenius ML, Stahle A. Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life. Scand J Med Sci Sports. 2008;18(2):154–61.CrossRefPubMed
36.
go back to reference Courneya KS, McKenzie DC, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Cook D, Jespersen D, Proulx C, et al. Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst. 2013;105(23):1821–32.CrossRefPubMed Courneya KS, McKenzie DC, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Cook D, Jespersen D, Proulx C, et al. Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst. 2013;105(23):1821–32.CrossRefPubMed
37.
go back to reference Adamsen L, Quist M, Andersen C, Moller T, Herrstedt J, Kronborg D, Baadsgaard MT, Vistisen K, Midtgaard J, Christiansen B, et al. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ. 2009;339:b3410.CrossRefPubMedPubMedCentral Adamsen L, Quist M, Andersen C, Moller T, Herrstedt J, Kronborg D, Baadsgaard MT, Vistisen K, Midtgaard J, Christiansen B, et al. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ. 2009;339:b3410.CrossRefPubMedPubMedCentral
38.
go back to reference Schmitt J, Lindner N, Reuss-Borst M, Holmberg HC, Sperlich B. A 3-week multimodal intervention involving high-intensity interval training in female cancer survivors: a randomized controlled trial. Physiol Rep. 2016;4(3):e12693. Schmitt J, Lindner N, Reuss-Borst M, Holmberg HC, Sperlich B. A 3-week multimodal intervention involving high-intensity interval training in female cancer survivors: a randomized controlled trial. Physiol Rep. 2016;4(3):e12693.
39.
go back to reference Nikander R, Sievanen H, Ojala K, Kellokumpu-Lehtinen PL, Palva T, Blomqvist C, Luoto R, Saarto T. Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients--a 12-month RCT. J Musculoskelet Neuronal Interact. 2012;12(3):127–35.PubMed Nikander R, Sievanen H, Ojala K, Kellokumpu-Lehtinen PL, Palva T, Blomqvist C, Luoto R, Saarto T. Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients--a 12-month RCT. J Musculoskelet Neuronal Interact. 2012;12(3):127–35.PubMed
40.
go back to reference Devin JL, Sax AT, Hughes GI, Jenkins DG, Aitken JF, Chambers SK, Dunn JC, Bolam KA, Skinner TL. The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial. J Cancer Surviv. 2016;10(3):467–79. Devin JL, Sax AT, Hughes GI, Jenkins DG, Aitken JF, Chambers SK, Dunn JC, Bolam KA, Skinner TL. The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial. J Cancer Surviv. 2016;10(3):467–79.
Metadata
Title
Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy
Authors
Y. Wengström
K. A. Bolam
S. Mijwel
C. J. Sundberg
M. Backman
M. Browall
J. Norrbom
H. Rundqvist
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3079-x

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