Effect of exercise on quality of life (QoL) in 198 older patients with cancer: A URCC NCORP nationwide RCT.

Background: Cancer and its treatment frequently impact QoL in patients. In older cancer patients, a small decrement in QoL is associated with significant functional impairment, disability, treatment discontinuation and decreased survival. Little is known about the role of exercise in improving QoL in older cancer patients undergoing active chemotherapy and the mechanistic association between inflammation and QoL. We conducted a secondary analysis of a nationwide phase III RCT to assess the effect of exercise on QoL in older cancer patients. Methods: We included 198 older cancer patients (aged ≥60 years) who were randomized to receive chemotherapy alone (C) or with EXCAP (Exercise for Cancer Patients). EXCAP is a home‐based progressive aerobic and resistance training program. We used ANCOVA to evaluate the effect of EXCAP on QoL (measured by the Functional Assessment of Cancer Therapy‐General, FACT‐G, and ‐ Cognitive Function, FACT‐Cog). Baseline values, gender and chemotherapy duration were adjusted. We assessed associations between changes in QoL and changes in inflammatory cytokines. Results: Median age was 66.7 ± 2.3 years, 92% were female and 77% had breast cancer. In terms of chemotherapy, 3‐week and 2‐week regimens were used for 72% and 28%, respectively. EXCAP group had better social (p=0.02), emotional (p=0.04) and physical (p=0.03) well‐being post‐intervention than the C group. There was also a positive trend for improvement in functional, cognitive and overall wellbeing (Table 1). In the EXCAP group, improved social well‐being was associated with decreases in the pro‐inflammatory cytokine, IL‐8 (r=0.30, p=0.03). Conclusions: Our analysis showed that exercise improves QoL in older cancer patients receiving active chemotherapy. Improvement in social well‐being may be mediated by reducing inflammation. Physicians should consider incorporating exercise when prescribing chemotherapy for older adults with cancer. (Table Presented).