TY - JOUR
T1 - Home-Based Exercise Prehabilitation During Preoperative Treatment for Pancreatic Cancer Is Associated With Improvement in Physical Function and Quality of Life
AU - Ngo-Huang, An
AU - Parker, Nathan H.
AU - Bruera, Eduardo
AU - Lee, Rebecca E.
AU - Simpson, Richard
AU - O’Connor, Daniel P.
AU - Petzel, Maria Q.B.
AU - Fontillas, Rhodora C.
AU - Schadler, Keri
AU - Xiao, Lianchun
AU - Wang, Xuemei
AU - Fogelman, David
AU - Sahai, Sunil K.
AU - Lee, Jeffrey E.
AU - Basen-Engquist, Karen
AU - Katz, Matthew H.G.
N1 - Funding Information:
Supplemental material, Supplementary_Table_1_PancOutcomes for Home-Based Exercise Prehabilitation During Preoperative Treatment for Pancreatic Cancer Is Associated With Improvement in Physical Function and Quality of Life by An Ngo-Huang, Nathan H. Parker, Eduardo Bruera, Rebecca E. Lee, Richard Simpson, Daniel P. O’Connor, Maria Q. B. Petzel, Rhodora C. Fontillas, Keri Schadler, Lianchun Xiao, Xuemei Wang, David Fogelman, Sunil K. Sahai, Jeffrey E. Lee, Karen Basen- Engquist and Matthew H. G. Katz in Integrative Cancer Therapies We would like to acknowledge Scientific Publications in the Research Medical Library at the University of Texas MD Anderson Cancer Center for their review of this manuscript. This study used the Patient-Reported Outcomes, Survey, and Population Research Shared Resource, which is supported by a Cancer Center Support Grant (CA 016672, Principal Investigator: R. DePinho; The University of Texas MD Anderson Cancer Center) from the National Cancer Institute, National Institutes of Health. Patient Reported Outcomes Measurement Information System (PROMIS) was funded with cooperative agreements from the National Institutes of Health Common Fund Initiative (U54AR057951, U01AR052177, U54AR057943, U54AR057926, U01AR057948, U01AR052170, U01AR057954, U01AR052171, U01AR052181, U01AR057956, U01AR052158, U01AR057929, U01AR057936, U01AR052155, U01AR057971, U01AR057940, U01AR057967, and U01AR052186). The contents of this article use data developed under PROMIS. These contents do not necessarily represent an endorsement by the US Federal Government or PROMIS. See www.nihpromis.org for additional information on the PROMIS initiative. Authors’ Note The data presented in this article were previously presented as a poster at the American Society for Preventive Oncology Annual Meeting (Parker NH, Ngo-Huang A, Basen-Engquist K, Petzel MQB, Fogelman D, Lee RE, O’Connor DP, Martinez VA, Katz MHG. Physical activity is associated with improved quality of life and functional fitness among patients receiving preoperative therapy for pancreatic cancer. American Society for Preventive Oncology Annual Meeting, New York, NY, April 2018). Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Knox Family Foundation; Center for Energy Balance in Cancer Prevention & Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment; Texas Chapter of the American College of Sports Medicine; Cancer Prevention & Research Institute of Texas Training Grant/MD Anderson Cancer Prevention Research Training Program (RP170259, Dr Shine Chang, Principal Investigator); the Bettie Willerson Driver Cancer Research Fund, and the National Institutes of Health/National Cancer Institute (Award Number P30CA016672; used the Clinical Trials Support Resource and the Biostatistics Resource Group). Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed Consent Informed consent was obtained from all individual participants included in the study. Trial Registration This trial was registered at clinicaltrials.gov : https://clinicaltrials.gov/ct2/show/NCT02295956 , registration NCT02295956. ORCID iD An Ngo-Huang https://orcid.org/0000-0003-4797-4147 Supplemental Material Supplemental material for this article is available online.
Funding Information:
We would like to acknowledge Scientific Publications in the Research Medical Library at the University of Texas MD Anderson Cancer Center for their review of this manuscript. This study used the Patient-Reported Outcomes, Survey, and Population Research Shared Resource, which is supported by a Cancer Center Support Grant (CA 016672, Principal Investigator: R. DePinho; The University of Texas MD Anderson Cancer Center) from the National Cancer Institute, National Institutes of Health. Patient Reported Outcomes Measurement Information System (PROMIS) was funded with cooperative agreements from the National Institutes of Health Common Fund Initiative (U54AR057951, U01AR052177, U54AR057943, U54AR057926, U01AR057948, U01AR052170, U01AR057954, U01AR052171, U01AR052181, U01AR057956, U01AR052158, U01AR057929, U01AR057936, U01AR052155, U01AR057971, U01AR057940, U01AR057967, and U01AR052186). The contents of this article use data developed under PROMIS. These contents do not necessarily represent an endorsement by the US Federal Government or PROMIS. See www.nihpromis.org for additional information on the PROMIS initiative. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Knox Family Foundation; Center for Energy Balance in Cancer Prevention & Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment; Texas Chapter of the American College of Sports Medicine; Cancer Prevention & Research Institute of Texas Training Grant/MD Anderson Cancer Prevention Research Training Program (RP170259, Dr Shine Chang, Principal Investigator); the Bettie Willerson Driver Cancer Research Fund, and the National Institutes of Health/National Cancer Institute (Award Number P30CA016672; used the Clinical Trials Support Resource and the Biostatistics Resource Group).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019
Y1 - 2019
N2 - Purpose: To investigate relationships among physical activity, changes in physical function, and health-related quality of life (HRQOL) among patients with pancreatic adenocarcinoma enrolled in a home-based exercise prehabilitation program. Methods: Patients with resectable pancreatic adenocarcinoma receiving preoperative chemotherapy and/or chemoradiation were enrolled on this prospective, single-arm trial and were advised to perform ≥60 minutes each of moderate-intensity aerobic exercise and strengthening exercise weekly. Activity was measured via self-report and accelerometers, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary activity (SA). Physical function measures at baseline and restaging follow-up included 6-minute walk test (6MWT), 5 times sit-to-stand (5×STS), handgrip strength (HGS), 3-m walk for gait speed (GS), and the PROMIS Physical Function Short Form. HRQOL was measured via the FACT-Hep questionnaire. Results: Fifty participants with mean age 66 years (standard deviation = 8 years) were enrolled. The 6MWT, 5×STS, and GS significantly improved from baseline to restaging follow-up (P=.001, P=.049, and P=.009, respectively). Increases in self-reported aerobic exercise, weekly MVPA, and LPA were associated with improvement in 6MWT (β=.19, P=.048; β=.18, P=.03; and β=.08, P=.03, respectively) and self-reported physical functioning (β=.02, P=.03; β=.03, P=.005; and β=.01, P=.02, respectively). Increased weekly LPA was associated with increased HRQOL (β=.03, P=.02). Increased SA was associated with decreased HRQOL (β=-.02,P=.01). Conclusions: Patients with potentially resectable pancreatic cancer exhibit meaningful improvement in physical function with prehabilitation; physical activity was associated with improved physical function and HRQOL. These data highlight the importance of physical activity during treatment for pancreatic cancer.
AB - Purpose: To investigate relationships among physical activity, changes in physical function, and health-related quality of life (HRQOL) among patients with pancreatic adenocarcinoma enrolled in a home-based exercise prehabilitation program. Methods: Patients with resectable pancreatic adenocarcinoma receiving preoperative chemotherapy and/or chemoradiation were enrolled on this prospective, single-arm trial and were advised to perform ≥60 minutes each of moderate-intensity aerobic exercise and strengthening exercise weekly. Activity was measured via self-report and accelerometers, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary activity (SA). Physical function measures at baseline and restaging follow-up included 6-minute walk test (6MWT), 5 times sit-to-stand (5×STS), handgrip strength (HGS), 3-m walk for gait speed (GS), and the PROMIS Physical Function Short Form. HRQOL was measured via the FACT-Hep questionnaire. Results: Fifty participants with mean age 66 years (standard deviation = 8 years) were enrolled. The 6MWT, 5×STS, and GS significantly improved from baseline to restaging follow-up (P=.001, P=.049, and P=.009, respectively). Increases in self-reported aerobic exercise, weekly MVPA, and LPA were associated with improvement in 6MWT (β=.19, P=.048; β=.18, P=.03; and β=.08, P=.03, respectively) and self-reported physical functioning (β=.02, P=.03; β=.03, P=.005; and β=.01, P=.02, respectively). Increased weekly LPA was associated with increased HRQOL (β=.03, P=.02). Increased SA was associated with decreased HRQOL (β=-.02,P=.01). Conclusions: Patients with potentially resectable pancreatic cancer exhibit meaningful improvement in physical function with prehabilitation; physical activity was associated with improved physical function and HRQOL. These data highlight the importance of physical activity during treatment for pancreatic cancer.
KW - outcome measures
KW - pancreatic cancer
KW - physical function
KW - prehabilitation
KW - preoperative exercise
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U2 - 10.1177/1534735419894061
DO - 10.1177/1534735419894061
M3 - Article
C2 - 31858837
AN - SCOPUS:85077164903
SN - 1534-7354
VL - 18
JO - Integrative Cancer Therapies
JF - Integrative Cancer Therapies
ER -