Effect of exercise adjunct to radiation and androgen deprivation therapy on patient-reported treatment toxicity in men with prostate cancer: a secondary analysis of two randomised controlled trials.

Abstract

PURPOSE\nPhysical inactivity, in addition to clinical factors, has been associated with higher levels of late pelvic symptoms in prostate cancer (PCa) patients after radiotherapy. The aim of this study was to investigate the effect of a structured multicomponent exercise program comprised of aerobic and resistance training as well as impact loading on the prevalence and severity of symptoms commonly resulting from androgen deprivation therapy (ADT) and pelvic radiotherapy.\n\n\nMETHODS\nWe performed a secondary analysis of pooled data from two randomised controlled trials that investigated the role of exercise on treatment-related side-effects in PCa patients receiving ADT. Patients were included in the analysis if they had undergone radiotherapy during the intervention in addition to ADT. Patient-reported quality of life, functional and symptom scales were assessed using the EORTC QLQ-C30 and PR25 before and after 6 months of exercise or usual care (UC).\n\n\nRESULTS\nOne-hundred and fifteen PCa patients receiving ADT, aged 47-84 years, who also underwent radiotherapy were included in the analysis (exercise, n=72; UC, n=43). There was a significant reduction in physical functioning (p=0.019) and increased fatigue (p=0.007) in the control group, with no change observed in the exercise group. Similarly, there was a trend towards reduced sexual activity in the control group (p=0.064), with a mean adjusted change of -7.1 points. Furthermore, the prevalence of clinically important pain at 6 months was lower in the exercise group compared with UC (18.1 vs. 37.2%, p=0.022). No between-group differences were found for urinary (p=0.473) or hormonal treatment-related symptoms (p=0.552).\n\n\nCONCLUSIONS\nExercise during concomitant hormone and radiation treatment for men with PCa may mitigate some adverse changes in patient-reported fatigue, physical functioning and possibly sexual activity. The promotion and provision of exercise to counter a range of treatment-related adverse effects in PCa patients undergoing radiotherapy and ADT should be actively encouraged.