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01.01.2024 | Research

Association of self-directed walking with toxicity moderation during chemotherapy for the treatment of early breast cancer

verfasst von: KA Nyrop, A Page, AM Deal, C Wagoner, EA Kelly, Gretchen G. Kimmick, Anureet Copeland, JoEllen Speca, William A. Wood, HB Muss

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2024

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Abstract

Background

In the field of exercise oncology, there is a need to quantify the potential benefits of moderate, self-directed physical activity during active treatment. In a pooled analysis of three identical single-arm intervention studies, we investigate the association of activity tracker steps with patient-reported toxicities during chemotherapy.

Methods

Women with early breast cancer who were enrolled in the intervention studies reported their symptom severity every 2–3 weeks throughout chemotherapy, and daily steps were documented through a Fitbit activity tracker. Relative risks (RR) and 95% confidence intervals (CI) were calculated using Poisson regression models with robust variance. For outcomes significant in unadjusted models, adjusted RRs were calculated controlling for race, age, and education level. Tracker step cut point (high step, low step) was determined by the means. Cumulative incidence functions of moderate, severe, and very severe (MSVS) symptoms were estimated using the Kaplan-Meier method and compared using a Cox proportional hazard model.

Results

In a sample of 283 women, mean age was 56 years and 76% were White. Mean tracker-documented steps/week were 29,625, with 55% walking below the mean (low step) and 45% above (high step). In multivariable analysis, high step patients had lower risk for fatigue [RR 0.83 (0.70, 0.99)] (p = 0.04), anxiety [RR 0.59 (0.42, 0.84)] (p = 0.003), nausea [RR 0.66 (0.46, 0.96)] (p = 0.03), depression [RR 0.59 (0.37, 0.03)] (p = 0.02), and ≥ 6 MSVS symptoms [RR 0.73 (0.54, 1.00)] (p = 0.05) and had 36% lower risk for dose reductions [RR 0.64 (95% CI 0.43, 0.97)] (p = 0.03).

Conclusion

Self-directed walking at a rate of at least 30,000 steps/week may moderate the severity of treatment side effects during chemotherapy for early breast cancer.

Trial numbers

NCT02167932, NCT02328313, NCT03761706.

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Titel: Association of self-directed walking with toxicity moderation during chemotherapy for the treatment of early breast cancer
verfasst von: KA Nyrop
A Page
AM Deal
C Wagoner
EA Kelly
Gretchen G. Kimmick
Anureet Copeland
JoEllen Speca
William A. Wood
HB Muss
Publikationsdatum: 01.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 1/2024
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-023-08275-4

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Association of self-directed walking with toxicity moderation during chemotherapy for the treatment of early breast cancer