Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Feb;52(2):278-286.
doi: 10.1249/MSS.0000000000002151.

"Chemotherapy-periodized" Exercise to Accommodate for Cyclical Variation in Fatigue

Amy A Kirkham  1 , Kelcey A Bland  2 , David S Zucker  3 , Joshua Bovard  4 , Tamara Shenkier  5 , Donald C McKenzie  4 , Margot K Davis  6 , Karen A Gelmon  5 , Kristin L Campbell
Affiliations
Randomized Controlled Trial

"Chemotherapy-periodized" Exercise to Accommodate for Cyclical Variation in Fatigue

Amy A Kirkham et al. Med Sci Sports Exerc. 2020 Feb.

Abstract

Purpose: The purpose of this study was to provide a rationale for "chemotherapy-periodized" exercise by characterizing cyclical variations in fatigue and exercise response across a chemotherapy cycle and comparing exercise adherence during chemotherapy between a prescription that is periodized according to chemotherapy cycle length and a standard linearly progressed prescription.

Methods: Women with breast cancer who were prescribed taxane-based chemotherapy were randomly assigned to a supervised aerobic and resistance exercise program after a chemotherapy-periodized exercise prescription (n = 12) or to usual care during chemotherapy (n = 15). Fatigue and steady state exercise responses were assessed in both groups before the first taxane treatment and across the third treatment (i.e., 0-3 d prior and 3-5 d after the third treatment, and 0-3 d before the fourth treatment) to assess cyclical variations. Adherence to the chemotherapy-periodized exercise prescription was compared with adherence to a standard linear prescription from a prior study in a similar population (n = 51).

Results: Fatigue increased from baseline (marginal mean ± standard error: 3.2 ± 0.4) to before the third treatment (4.1 ± 0.4, P = 0.025), then peaked at 3 to 5 d after the third treatment (5.1 ± 0.4, P = 0.001), before recovering before the fourth treatment (4.3 ± 0.5, P = 0.021). The peak in fatigue at 3 to 5 d post-third treatment corresponded to a decrease in steady state exercise oxygen consumption (V˙O2) (P = 0.013). Compared with a standard linear exercise prescription during chemotherapy, a chemotherapy-periodized exercise prescription resulted in higher attendance during the week after chemotherapy (57% ± 30% vs 77% ± 28%, P = 0.04) and overall attendance (63% + 25% vs 78% ± 23%, P = 0.05).

Conclusions: Fatigue and exercise V˙O2 vary across a chemotherapy cycle. A chemotherapy-periodized exercise prescription that accommodates cyclical variations in fatigue may increase adherence to supervised exercise.

PubMed Disclaimer

References

    1. Kirkham AA, Bland KA, Sayyari S, Campbell KL, Davis MK. Clinically relevant physical benefits of exercise interventions in breast cancer survivors. Curr Oncol Rep. 2016;18(2):12.
    1. Argyriou AA, Koltzenburg M, Polychronopoulos P, Papapetropoulos S, Kalofonos HP. Peripheral nerve damage associated with administration of taxanes in patients with cancer. Crit Rev Oncol Hematol. 2008;66(3):218–28.
    1. Antoine JC, Camdessanché JP. Peripheral nervous system involvement in patients with cancer. Lancet Neurol. 2007;6(1):75–86.
    1. Kim WY, Woo SU, Seo JH, Son GS, Lee JB, Bae JW. Toxicities, dose reduction and delay of docetaxel and paclitaxel chemotherapy in breast cancer without distant metastases. J Cancer Res Ther. 2011;7(4):412–5.
    1. Qi WX, Shen Z, Lin F, et al. Paclitaxel-based versus docetaxel-based regimens in metastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials. Curr Med Res Opin. 2013;29(2):117–25.

Publication types

LinkOut - more resources