TY - JOUR
T1 - Effects and moderators of exercise on quality of life and physical function in patients with cancer
T2 - 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 - Galvao, 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 Jose
AU - Nollet, Frans
AU - Wenzel, Jennifer
AU - Wiskemann, Joachim
AU - Verdonck-de Leeuw, Irma M.
AU - Brug, Johannes
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control group), and exercise-related (exercise frequency, intensity, type, time) characteristics.Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications.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 (beta = 0.15, 95%Cl = 0.10;0.20) and PF (beta = 0.18, 95%CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (beta(difference_in_effect) = 0.13, 95%CI = 0,03;0.22) and PF (beta(difrerence_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. (C) 2016 The Authors. Published by Elsevier Ltd.
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 (beta = 0.15, 95%Cl = 0.10;0.20) and PF (beta = 0.18, 95%CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (beta(difference_in_effect) = 0.13, 95%CI = 0,03;0.22) and PF (beta(difrerence_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. (C) 2016 The Authors. Published by Elsevier Ltd.
KW - Exercise
KW - Quality of life
KW - Physical function
KW - Neoplasm
KW - Individual patient data meta-analysis
KW - RANDOMIZED CONTROLLED-TRIAL
KW - BREAST-CANCER
KW - PROSTATE-CANCER
KW - AEROBIC EXERCISE
KW - PARTICIPANT DATA
KW - ADJUVANT CHEMOTHERAPY
KW - RESISTANCE EXERCISE
KW - HIGH-INTENSITY
KW - CARDIORESPIRATORY FITNESS
KW - ANDROGEN SUPPRESSION
U2 - 10.1016/j.ctrv.2016.11.010
DO - 10.1016/j.ctrv.2016.11.010
M3 - (Systematic) Review article
C2 - 28006694
SN - 0305-7372
VL - 52
SP - 91
EP - 104
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
ER -