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Home-based exercise during preoperative therapy for pancreatic cancer

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Abstract

Purpose

Exercise concurrent with neoadjuvant chemotherapy and/or chemoradiation for pancreatic adenocarcinoma (PDAC) may mitigate the decline in function that may occur as a result of the disease or its treatment in the preoperative period. The primary objective of this single-arm prospective trial was to determine adherence to a home-based exercise program administered during preoperative therapy.

Methods

Twenty patients from a quaternary cancer center with potentially resectable PDAC were enrolled. Patients were prescribed a minimum of 120 min of moderate-intensity exercise weekly: at least 60 min of aerobic exercise and 60 min of resistance exercise. Self-reported exercise was recorded in daily logs. Functional and survey measures were collected upon enrollment, following preoperative therapy, and 1 month after surgery.

Results

Fifteen out of 20 patients participated in the program. They reported a mean (standard deviation (SD)) of 98.6 (69.8) min of aerobic exercise weekly and 57.4 (36.0) min of strengthening exercise weekly over a median of 17 weeks (range, 5–35 weeks) of preoperative therapy, for a mean (SD) of 156.0 (64.5) min of total exercise weekly. Eighty percent reported a mean of least 120 min of total exercise weekly during preoperative therapy. Patients with low baseline physical activity based on the International Physical Activity Questionnaire significantly increased their preoperative physical activity (p = .01). There were no adverse events associated with the exercise program.

Conclusions

Patients with PDAC will participate in a home-based exercise program of aerobic and strengthening exercise and will increase physical activity, concurrent with preoperative chemotherapy and/or chemoradiation.

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Acknowledgements

This study used the Patient-Reported Outcomes, Survey, and Population Research Shared Resource, which is supported by a Cancer Center Support Grant (CA 016672, PI: R. DePinho, MD Anderson Cancer Center) from the National Cancer Institute, National Institutes of Health. We thank Karen Basen-Engquist, PhD, MPH of the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment, MD Anderson Cancer Center, for her input on the research design.

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.

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Author notes

  1. An Ngo-Huang, DO and Nathan H. Parker, PhD are co-primary authors and contributed equally to the creation of this manuscript.

Authors and Affiliations

  1. Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX, 77030, USA

    An Ngo-Huang & Eduardo Bruera

  2. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Nathan H. Parker, Maria Q. B. Petzel, Jason B. Fleming, Jeffrey E. Lee & Matthew H. G. Katz

  3. Department of Health and Human Performance, University of Houston, Houston, TX, USA

    Nathan H. Parker

  4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Xuemei Wang

  5. Department of Clinical Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Maria Q. B. Petzel

  6. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    David Fogelman

  7. Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Keri L. Schadler

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  1. An Ngo-Huang
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Contributions

Study conception and design: ANH, NHP, XW, MQBP, DF, MHGK. Acquisition of data: ANH, NHP, MQBP, DF, JBF, JEL, MHGK. Analysis and interpretation of data: ANH, NHP, XW, MHGK. Drafting of manuscript: ANH, NHP, MHGK. Critical revision of manuscript: ANH, NHP, XW, DF, KLS, EB, JEL, MHGK.

Corresponding author

Correspondence to An Ngo-Huang.

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Funding

This study used the Patient-Reported Outcomes, Survey, and Population Research Shared Resource for exercise equipment, which is supported by a Cancer Center Support Grant (CA 016672, PI: R. DePinho, MD Anderson Cancer Center) from the National Cancer Institute, National Institutes of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

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.

• This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ngo-Huang, A., Parker, N.H., Wang, X. et al. Home-based exercise during preoperative therapy for pancreatic cancer. Langenbecks Arch Surg 402, 1175–1185 (2017). https://doi.org/10.1007/s00423-017-1599-0

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  • DOI: https://doi.org/10.1007/s00423-017-1599-0

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