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

作者：Galvao Daniel A^*; Spry Nigel; Denham James; Taaffe Dennis R; Cormie Prue; Joseph David; Lamb David S; Chambers Suzanne K; Newton Robert U

来源：European Urology, 2014, 65(5): 856-864.

DOI：10.1016/j.eururo.2013.09.041

• Androgen deprivation
• Musculoskeletal system
• Resistance training
• Physical exercise
• Physical function
• Quality of life

Background: Long-term prostate cancer (PCa) survivors are at increased risk for comorbidities and physical deconditioning. %26lt;br%26gt;Objective: To determine the effectiveness of a year-long randomised controlled trial of exercise training in PCa survivors %26gt;5 yr postdiagnosis on physical functioning. %26lt;br%26gt;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. %26lt;br%26gt;Intervention: Supervised resistance and aerobic exercise or printed educational material about physical activity. %26lt;br%26gt;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. %26lt;br%26gt;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 %26lt; 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 %26lt; 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. %26lt;br%26gt;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.

• 出版日期2014-5