Are The ACSM Exercise Guidelines Safe And Achievable For Women Receiving Chemotherapy For Ovarian Cancer?

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Jones, Tamara
Spence, Rosalind
Sandler, Carolina
Obermair, Andreas
Friedlander, Michael
Mileshkin, Linda
Davis, Alison
Janda, Monika
Eakin, Elizabeth
Barnes, Elizabeth
Beesley, Vanessa
Gordon, Louisa
Brand, Alison
Hayes, Sandra
Griffith University Author(s)
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PURPOSE: ECHO is a phase III, randomised, controlled trial (ACTRN12614001311640) evaluating the effect of exercise during first-line chemotherapy for women with ovarian cancer on progression-free survival (target sample, n=500). We report here preliminary findings on exercise safety and dose undertaken for the consenting women randomised to the exercise intervention.

METHODS: Exercise-related adverse events (EAEs) were classified as grades 1-5 according to CTC-AE, and were assessed for exercise causality (not related, unlikely, possible, likely, certain) and whether modification to exercise prescription was required. Weekly exercise dose undertaken was recorded as minutes, intensity, mode and frequency. Data were collected by an Exercise Physiologist during weekly contact with participants over the intervention duration (duration is based on length of neo- and/or adjuvant chemotherapy; ~18 weeks). Exercise was considered safe if there were no grade 3 or higher EAEs, and in line with the new ACSM guidelines, the intervention was considered feasible for a participant if they completed ≥150 minutes of weekly, mixed-mode exercise ≥75% of intervention weeks.

RESULTS: To date, we have recruited 225 women, 113 of whom have been randomised to the exercise intervention. One or more EAEs was reported by 42% of participants in the exercise intervention. Typical grade 1 (85% of EAEs reported) and 2 EAEs included delayed onset muscle soreness or adverse fluctuations in treatment-related symptoms (e.g., pain at surgical site, fatigue) that may have been caused by exercise. While no grade 3 or higher EAEs were reported, 58% required exercise intervention modification (i.e., change in minutes, intensity, mode or frequency). The median weekly minutes of exercise reported was 186.5 (range: 0-610), yet only 34% of participants completed ≥150min/week of mixed-mode exercise for ≥75% of the intervention duration.

CONCLUSION: Exercise is proving safe during chemotherapy for ovarian cancer. Further, while an average of 150 minutes of mixed-mode exercise each week is feasible, flexibility in prescription is needed to accommodate individual circumstances (such as EAEs or typical treatment-related fluctuations in side effects) that inevitably present throughout the course of chemotherapy for ovarian cancer.

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Medicine & Science in Sports & Exercise

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Jones, T; Spence, R; Sandler, C; Obermair, A; Friedlander, M; Mileshkin, L; Davis, A; Janda, M; Eakin, E; Barnes, E; Beesley, V; Gordon, L; Brand, A; Hayes, S, Are The ACSM Exercise Guidelines Safe And Achievable For Women Receiving Chemotherapy For Ovarian Cancer?, Medicine & Science in Sports & Exercise, 2020, 52 (7S), pp. 483-484