A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with Androgen Suppression and Radiation from TROG 03.04 RADAR

Abstract

Background: Long-term prostate cancer (PCa) survivors are at increased risk for comorbidities and physical deconditioning. Objective: To determine the effectiveness of a year-long randomised controlled trial of exercise training in PCa survivors >5 yr postdiagnosis on physical functioning. Design, setting, and participants: Between 2010 and 2011, 100 long-term PCa survivors from Trans- Tasman Radiation Oncology Group 03.04 Randomised Androgen Deprivation and Radiotherapy previously treated with androgen-deprivation therapy and radiation therapy were randomly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme (n = 50) or printed educational material about physical activity (n = 50) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zealand. Intervention: Supervised resistance and aerobic exercise or printed educational material about physical activity. Outcome measurements and statistical analysis: The primary end point was a 400-m walk as a measure of cardiovascular fitness. Secondary end points were physical function, patient-reported outcomes, muscle strength, body composition, and biomarkers. Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values. Results and limitations: Participants undergoing supervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo ( 19 s [p = 0.029]) and 12 mo ( 13 s [p = 0.028]) and better lower-body physical function across the 12-mo period ( p < 0.01). Supervised exercise also improved self-reported physical functioning at 6 ( p = .006) and 12 mo ( p = 0.002), appendicular skeletal muscle at 6 mo ( p = 0.019), and objective measures of muscle strength at 6 and 12 mo ( p < 0.050). Limitations included the restricted number of participants undertaking body composition assessment, no blinding to group assignment for physical functioning measures, and inclusion of well-functioning individuals. Conclusions: Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness, physical function, muscle strength, and self-reported physical functioning at 6 mo. Importantly, these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo.