Cost evaluation of an exercise oncology intervention: The exercise in all chemotherapy trial

Potiaumpai, Melanie; Doerksen, Shawna E.; Chinchilli, Vernon M.; Wu, Hongke; Wang, Li; Lintz, Rachel; Schmitz, Kathryn H.

doi:10.1002/cnr2.1490

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Evaluation of the benefits and rationale for insurance (or Medicare) to reimburse or subsidize the cost of exercise and nutrition counseling or supervised exercise in cancer survivors is warranted, and cost-effectiveness analyses should become standard for every intervention. 9,10 Second, exercise is medicine, and these results support this. The median overall survival difference was striking between the groups-19 years for exercisers and 14 years for nonexercisers, with the difference appearing within 5 years and persisting at least 20 years after diagnosis.…”

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confidence: 67%

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Meeting Exercise Recommendations Is Beneficial for Cancer Survivors

Kenfield,

Chan

2023

JCO

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confidence: 67%

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confidence: 99%

Meeting Exercise Recommendations Is Beneficial for Cancer Survivors

Kenfield,

Chan

2023

JCO

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“…The trial was registered (Clinical Trials.gov NCT03461471), the Penn State Human Subjects protection office approved the protocol, and all patients provided informed consent prior to inclusion in the study. The methodology and results of the trial have been published 14,15 . The present analysis is a post hoc analysis of a subset of data relevant to the study participants diagnosed with pancreatic cancer who were consented between March 2017 and September 2018.…”

Section: Methodsmentioning

confidence: 99%

“…The methodology and results of the trial have been published. 14,15 The present analysis is a post hoc analysis of a subset of data relevant to the study participants diagnosed with pancreatic cancer who were consented between March 2017 and September 2018.…”

Section: Methodsmentioning

confidence: 99%

Exercise intervention during chemotherapy for pancreatic cancer: Changes in body composition and function

Schmitz

Boutin

Yoon

et al. 2023

JCSM Rapid Communications

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Background Patients with pancreatic cancer often lose weight during chemotherapy with associated changes in body composition. The goal of the present analysis was to describe changes in body composition in pancreatic cancer patients on an exercise regimen. The long‐term goal is to determine whether an exercise intervention may attenuate changes in body composition and function. Methods Twenty‐two pancreatic cancer patients of all stages who were to receive chemotherapy were recruited into a pre‐post exercise intervention study. A standard exercise prescription was individualized to include aerobic, resistance, stretch, and balance exercises. Pre‐ and post‐intervention computed tomography‐derived measures of body composition [skeletal muscle index (SMI), skeletal muscle density, visceral fat area, and subcutaneous fat area] and physical function measures (grip strength, timed up and go, 30‐s chair stand, and tandem balance stand) were evaluated using paired t‐tests, χ2 tests, and Pearson correlation coefficients. Results The subjects were, on average, 62 years of age, 55% were female, 95% non‐Hispanic White, and 45% were Stage IV. Body composition changes included a median 4.6% decrease in SMI (P = 0.04), 7.91% increase in skeletal muscle density (P = 0.05), 25.07% decrease in visceral fat area (P = 0.0001), and 22.08% decrease in subcutaneous fat area (P = 0.001). Adherence to aerobic and strength exercise was 65% and 57%, respectively. Some physical function measures improved, though not significantly: chair stands increased from a mean of 11.5 to 13.0 (P = 0.59) and timed up and go improved from a mean of 11.7 to 10.3 (P = 0.26). Change in right hand grip strength was marginally positively associated with changes in SMI (r = 0.53, P = 0.06). Improvements in skeletal muscle density were seen in 63% of patients, including Stage IV patients but did not correlate with change in function. Conclusions Exercise is feasible during neoadjuvant chemotherapy for pancreatic cancer patients of all stages and may assist with maintaining physical function and improving body composition. Further research is needed.

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“…9,10 The accumulation of these potential benefits could help reduce healthcare utilization. 10,11 The role of fitness capacity as a surrogate marker of overall health is understudied in relationship to RDI. To our knowledge, there are only two studies that report predictors of chemotherapy completion related to exercise participation or fitness.…”

Section: Introductionmentioning

confidence: 99%

Exercise during chemotherapy: Friend or foe?

et al. 2023

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Background A higher chemotherapy completion rate is associated with better outcomes including treatment efficacy and overall survival. Exercise may have the potential to improve relative dose intensity (RDI) by reducing the frequency and severity of chemotherapy‐related toxicities. We examined the association between exercise adherence and RDI and possible clinical‐ and health‐related fitness predictors of RDI. Methods Chemotherapy records were extracted from the electronic medical record for patients enrolled in the ENACT trial (n = 105). Chemotherapy completion was assessed using average RDI. A threshold of 85% was established for “high” versus “low” RDI. Logistic regression analyses were used to estimate the associations between the clinical‐ and health‐related fitness predictors of RDI. Results Patients with breast cancer (BC) had a significantly higher average RDI (89.8% ± 17.6%) compared with gastrointestinal cancer (GI) (76.8% ± 20.9%, p = 0.004) and pancreatic cancer (PC) (65.2% ± 20.1%, p < 0.001). Only 25% of BC patents required a dose reduction compared to 56.3% of GI and 86.4% of PC patients. Cancer site was significantly associated with RDI. Compared with BC, patients with GI (β = −0.12, p = 0.03) and PC (β = −0.22, p = 0.006) achieved significantly lower RDI. Every 2.72 unit increase in overall exercise adherence led to a significant 7% decrease in RDI (p = 0.001) in GI patients. Metastatic GI patients had a 15% RDI increase for every 2.72 unit increase in exercise adherence (p = 0.04). Conclusion Exercise is a supportive therapy that has potential to enhance chemotherapy tolerance and completion. The relationship between exercise adherence and RDI is influenced by factor such as cancer site and treatment type. Special attention must be paid to how exercise is prescribed to ensure that exercise adherence does not negatively affect RDI. Cancer site, exercise dosage, and multimodal interventions to address toxicities are key areas identified for future research.

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Cost evaluation of an exercise oncology intervention: The exercise in all chemotherapy trial

Cited by 8 publications

References 31 publications

Meeting Exercise Recommendations Is Beneficial for Cancer Survivors

Meeting Exercise Recommendations Is Beneficial for Cancer Survivors

Exercise intervention during chemotherapy for pancreatic cancer: Changes in body composition and function

Exercise during chemotherapy: Friend or foe?

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