Table 1.
Summary of randomized controlled trials for effects of exercise on cardiovascular outcomes during cancer treatment
| Study (year) | N | Cohort, settinga | Baseline CVD | Cardiotoxic cancer therapies | Modality, intensity, frequency (day/week), duration (weeks) | Cardiovascular outcomes | Protocol adherence LTF % |
|---|---|---|---|---|---|---|---|
| MacVicar et al. (1989) (25) | 45 | Breast cancer patients: AT, stretching, UC | NR | Adjuvant CT | CE | VO2p | NR |
| 60–85% HRR | AT: 40% increase | LTF: 27% | |||||
| 3 days/week | UC: NC | ||||||
| 10 weeks | P = 0.05 | ||||||
| Segal et al. (2001) (26) | 123 | Breast cancer patients: AT, self-directed AT, UC | NR | Previous XRT: 37% | TM | VO2p (estimated) | NR |
| Most common CT regimens: Fluorouracil, doxorubicin and cyclophosphamide: 35% | 50–60% VO2p | Supervised: 2.4% increase | LTF: 27% | ||||
| 3–5 days/week | Self: 3.5% increase | ||||||
| Adriamycin and cyclophosphamide: 31% | 26 weeks | UC: NC | |||||
| P = NS | |||||||
| Kim et al. (2006) (27) | 41 | Breast cancer patients: AT, UC | None | CT: 40.9% | CE, TM, or walking, jogging, running on track | VO2p | 78.3% |
| XRT: 31.8% | Moderate to High | AT: 8.3% increase | NR | ||||
| Combination: 27.3% | 3 days/week | UC: 2.1% increase | |||||
| 8 weeks | P < 0.001 | ||||||
| Resting SBP | |||||||
| AT: t39 = 2.09 | |||||||
| UC: NC | |||||||
| P < 0.05 | |||||||
| Courneya et al. (2007) (28) | 242 | Breast cancer patients: AT, RT, or UC | NR | Taxane CT: 31% | AT: CE, ET, TM | VO2p | AT: 93% |
| Non-taxane CT: 61% | 60–80% VO2p | AT: 0.2% increase | RT: 96% | ||||
| RT: 8–12 reps | RT: 5% decrease | LTF: 9% | |||||
| 60–70 RM | UC: 6% decrease | ||||||
| 3 days/week | P = 0.006 | ||||||
| 17 weeks | |||||||
| Daley et al. (2007) (29) | 108 | Breast cancer patients: AT, UC | None | Exercise | AT: 1:1 supervised therapy | 8-minute TM walk test | 77% |
| CT: 79.4% | 65–85% max HR | AT versus UC | NR | ||||
| XRT: 79.4% | 3 days/week | P = 0.002 | |||||
| Control | 8 weeks | ||||||
| CT: 73% | |||||||
| XRT: 78.9% | |||||||
| Courneya et al. (2009) (30) | 122 | Lymphoma patients: AT or UC | HTN 29% | CT: % NR | CE | VO2p | 95% |
| DLD 30% | 60–100% VO2p | AT: 17% increase | LTF: 11% | ||||
| 3 days/week | UC: 2% decrease | ||||||
| 12 weeks | P = 0.021 | ||||||
| Segal et al. (2009) (31) | 121 | Prostate cancer: AT, RT, UC | NR | XRT: % NR | AT: CE, ET, TM | VO2p | NR |
| ADT: 61.2% | 50–75% VO2p | AT: 0.1% increase | LTF: 7% | ||||
| RT: 8–12 reps | RT: 0.5% increase | ||||||
| 60–70% RM | UC: 5% decrease | ||||||
| 3 days/week | P = 0.01 | ||||||
| 24 weeks | |||||||
| Courneya et al. (2013) (32) | 301 | Breast cancer patients: AT, high-dose AT, combined AT/RT | Obese 23% | Taxane: 74.1% | AT: CE, ET, TM, row | VO2p | NR |
| Trastuzumab: 16.6% | RT: 8–12 reps | AT: 12% decrease | LTF: 7% | ||||
| Neither: 9.3% | 60–70% RM | High-dose AT: 9% decrease | |||||
| 3 days/week | Combined: 13% decrease | ||||||
| 16 weeks | P = 0.03 | ||||||
| Jones et al. (2013) (33) | 20 | Breast cancer patients: AT, UC | NR | Neoadjuvant CT | CE | VO2p | 66% |
| 55–100% VO2p | AT: 13% increase | LTF: 5% | |||||
| 3 days/week | UC: 9% decrease | ||||||
| 12 weeks | P = NS | ||||||
| Samuel et al. (2013) (34) | 48 | Head and neck cancer patients: AT or RT, UC | NR | CT: % NR | AT: walking | 6-minute walk test | Adherence not measured |
| 3–5/10 perceived exertion | AT/RT: 42 m increase | ||||||
| RT: 8–12 reps | UC: 96 m decrease | ||||||
| 5 days/week | P < 0.001 | ||||||
| 6 weeks | |||||||
| Study (year) | N | Cohort, settinga | Baseline CVD | Cardiotoxic cancer therapies | Modality, intensity, frequency (day/week), duration (weeks) | Cardiovascular outcomes | Protocol adherence LTF % |
| Hornsby et al. (2014) (35) | 20 | Breast cancer patients: AT, UC | NR | Neoadjuvant doxorubicin + cyclophosphamide | CE | VO2p | 82% |
| Moderate to high intensity | AT: 13.3% increase | NR | |||||
| 3 days/week | UC: 8.6% decrease | ||||||
| 12 weeks | P < 0.05 | ||||||
| Moller et al. (2015) (36) | 45 | Breast and colon cancer patients: hospital or home-based intervention versus UC | NR | Neoadjuvant CT | Home: walking with pedometer | Peak VO2 decreased across study groups 12% | NR |
| Hospital: bikes, resistance and circuit training, dance 3 days/week | P = NS | NR | |||||
| 12 weeks | |||||||
| Van Waart et al. (2015) (37) | 230 | Breast or colon cancer patients: home or supervised AT, CT, UC | NR | Adjuvant CT | Home AT: 12–14 Borg Score | Estimated exercise capacity | NR |
| XRT: 78% | 50–80% maximal workload | Home: 9% decrease | LTF: 11% | ||||
| 5 days/week | Supervised: 14% decrease | ||||||
| NR | UC: 18% decrease | ||||||
| P < 0.001 | |||||||
| Gilbert et al. (2016) (38) | 50 | Prostate cancer: Exercise, UC | Prior MI: 8% | Androgen deprivation therapy | CE, TM, row | FMD of the brachial artery | 93% |
| Angina: 12% | 55–75% max HR | P = 0.04 | NR | ||||
| HTN: 64% | 3 days/week | ||||||
| HTN since ADT: 12% | 12 weeks | ||||||
| Scott et al. (2018) (8) | 65 | Breast cancer patients with metastatic disease: AT, stretching (control) | HTN, DLD, DM, or CAD: 34% | CT: 57% | 55–100% VO2p | VO2p | NR |
| 3days/weeks | AT and control: P = NS | LTF: 3% | |||||
| 12weeks |
Bold value indicates statistically significant of P values.
ADT, androgen deprivation therapy; AT, aerobic training; CE, cycle ergometer; CT, chemotherapy; CVD, cardiovascular disease; DLD, dyslipidemia; ET, elliptical training; FMD, flow-mediated dilatation; HR, hazard ratio; HRR, heart rate reserve; HTN, hypertension; LTF%, lost to follow-up percent; NC, no change; NR, not reported; NS, non-significant; RCT, randomized controlled trial, RM, resistance maximum; RT, resistance training; TM, treadmill; UC, usual care; VO2p, peak oxygen consumption; XRT, radiation therapy.
a
Supervised unless otherwise stated.