A Multicenter Randomized Trial of the Effects of Exercise Dose and Type on Psychosocial Distress in Breast Cancer Patients Undergoing Chemotherapy
Mené au Canada auprès de 301 participantes, cet essai multicentrique randomisé évalue les effets d'exercices physiques, en fonction de leur intensité et de leur nature, pour réduire les symptômes dépressifs de patientes atteintes d'un cancer du sein et recevant une chimiothérapie
Background: Exercise may improve psychosocial distress in cancer patients; however, few studies have examined the effects of different types or doses of exercise, or whether exercise effects are related to baseline depression levels. Methods: In a multicenter trial in Canada, we randomized 301 breast cancer patients initiating chemotherapy to thrice weekly, supervised exercise consisting of either a standard dose of 25-30 minutes of aerobic exercise (STAN; n=96), a higher dose of 50-60 minutes of aerobic exercise (HIGH; n=101), or a combined dose of 50-60 minutes of aerobic and resistance exercise (COMB; n=104). The primary endpoint was depression assessed by the Center for Epidemiological Studies-Depression (CES-D) scale at baseline, twice during chemotherapy, and postchemotherapy. Secondary endpoints were anxiety, perceived stress, and self-esteem. Results: Repeated measures analyses of variance indicated that neither HIGH (mean difference= -0.9; 95% CI= +0.0 to -1.8; p=0.061) nor COMB (mean difference= -0.4; 95% CI= +0.5 to -1.3; p=0.36) were superior to STAN for managing depressive symptoms. In a planned subgroup analysis, there was a significant interaction with baseline depression levels (p for interaction=0.027) indicating that COMB and HIGH were effective for managing depressive symptoms in patients with clinical levels of depressive symptoms at baseline. Conclusions: Compared to a standard volume of aerobic exercise, higher volumes of exercise did not help manage depressive symptoms in unselected breast cancer patients receiving chemotherapy, but they were effective in patients with clinical levels of depressive symptoms at baseline. Impact: A phase III exercise trial targeting depressed breast cancer patients is warranted.