Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs

TY - JOUR

T1 - Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs

AU - Buffart, Laurien M

AU - Kalter, Joeri

AU - Sweegers, Maike G

AU - Courneya, Kerry S

AU - Newton, Robert U

AU - Aaronson, Neil K

AU - Jacobsen, Paul B

AU - May, Anne M

AU - Galvão, Daniel A

AU - Chinapaw, Mai J

AU - Steindorf, Karen

AU - Irwin, Melinda L

AU - Stuiver, Martijn M

AU - Hayes, Sandi

AU - Griffith, Kathleen A

AU - Lucia, Alejandro

AU - Mesters, Ilse

AU - van Weert, Ellen

AU - Knoop, Hans

AU - Goedendorp, Martine M

AU - Mutrie, Nanette

AU - Daley, Amanda J

AU - McConnachie, Alex

AU - Bohus, Martin

AU - Thorsen, Lene

AU - Schulz, Karl-Heinz

AU - Short, Camille E

AU - James, Erica L

AU - Plotnikoff, Ron C

AU - Arbane, Gill

AU - Schmidt, Martina E

AU - Potthoff, Karin

AU - van Beurden, Marc

AU - Oldenburg, Hester S

AU - Sonke, Gabe S

AU - van Harten, Wim H

AU - Garrod, Rachel

AU - Schmitz, Kathryn H

AU - Winters-Stone, Kerri M

AU - Velthuis, Miranda J

AU - Taaffe, Dennis R

AU - van Mechelen, Willem

AU - Kersten, Marie-José

AU - Nollet, Frans

AU - Wenzel, Jennifer

AU - Wiskemann, Joachim

AU - Verdonck-de Leeuw, Irma M

AU - Brug, Johannes

N1 - Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2017/1

Y1 - 2017/1

N2 - This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n=4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β=0.15, 95%CI=0.10;0.20) and PF (β=0.18, 95%CI=0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect=0.13, 95%CI=0.03;0.22) and PF (βdifference_in_effect=0.10, 95%CI=0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

AB - This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n=4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β=0.15, 95%CI=0.10;0.20) and PF (β=0.18, 95%CI=0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect=0.13, 95%CI=0.03;0.22) and PF (βdifference_in_effect=0.10, 95%CI=0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

KW - Exercise

KW - Humans

KW - Neoplasms

KW - Quality of Life

KW - Randomized Controlled Trials as Topic

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1016/j.ctrv.2016.11.010

DO - 10.1016/j.ctrv.2016.11.010

M3 - SCORING: Review article

C2 - 28006694

VL - 52

SP - 91

EP - 104

JO - CANCER TREAT REV

JF - CANCER TREAT REV

SN - 0305-7372

ER -