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J Natl Cancer Inst. 2013 Dec 4;105(23):1821-32. doi: 10.1093/jnci/djt297. Epub 2013 Oct 22.

Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial.

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Affiliations of authors: Faculty of Physical Education and Recreation (KSC, DC, CCF, LT), Department of Oncology (JRM), School of Public Health (YY), University of Alberta, Edmonton, Canada; School of Kinesiology (DCM, DJ, LBD), Department of Oncology (KG), University of British Columbia, Vancouver, Canada; Division of Medical Oncology, Cross Cancer Institute (JRM), Edmonton, Canada; Division of Medical Oncology, British Columbia Cancer Agency (KG), Vancouver, Canada; Department of Population Health Research, Alberta Health Services (CMF), Calgary, Canada; University of Ottawa Heart Institute (RRD), Ottawa, Canada; Ottawa Hospital Cancer Center (CP, EW, RJS), Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada (EW, RJS).



Exercise improves physical functioning and symptom management during breast cancer chemotherapy, but the effects of different doses and types of exercise are unknown.


A multicenter trial in Canada randomized 301 breast cancer patients to thrice-weekly supervised exercise during chemotherapy consisting of either a standard dose of 25 to 30 minutes of aerobic exercise (STAN; n = 96), a higher dose of 50 to 60 minutes of aerobic exercise (HIGH; n = 101), or a combined dose of 50 to 60 minutes of aerobic and resistance exercise (COMB; n = 104). The primary endpoint was physical functioning assessed by the Medical Outcomes Survey-Short Form (SF)-36. Secondary endpoints were other physical functioning scales, symptoms, fitness, and chemotherapy completion. All statistical tests were linear mixed model analyses, and the P values were two-sided.


Follow-up assessment of patient-reported outcomes was 99.0%. Adjusted linear mixed-model analyses showed that neither HIGH (+0.8; 95% confidence interval [CI] = -0.8 to 2.4; P = .30) nor COMB (+0.5; 95% CI = -1.1 to 2.1; P = .52] were superior to STAN for the primary outcome. In secondary analyses not adjusted for multiple comparisons, HIGH was superior to STAN for the SF-36 physical component summary (P = .04), SF-36 bodily pain (P = .02), and endocrine symptoms (P = .02). COMB was superior to STAN for endocrine symptoms (P = .009) and superior to STAN (P < .001) and HIGH (P < .001) for muscular strength. HIGH was superior to COMB for the SF-36 bodily pain (P = .04) and aerobic fitness (P = .03). No differences emerged for body composition or chemotherapy completion.


A higher volume of aerobic or combined exercise is achievable and safe during breast cancer chemotherapy and may manage declines in physical functioning and worsening symptoms better than standard volumes.

[Indexed for MEDLINE]

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