Randomized phase II study of a home-based walking intervention for radiation-related fatigue among older patients with breast cancer

• Published in: Journal of geriatric oncology 2021-03, Vol.12 (2), p.227-234
• Main Authors: VanderWalde, Noam A., Martin, Michelle Y., Kocak, Mehmet, Morningstar, Catherine, Deal, Allison M., Nyrop, Kirsten A., Farmer, Michael, Ballo, Matthew, VanderWalde, Ari, Muss, Hyman
• Format: Article
• Language: English
• Subjects: Breast neoplasms; Exercise; Fatigue; Geriatrics; Radiotherapy
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2020.09.013

Fatigue is a common side effect of radiation therapy and can dramatically affect the quality of life in older cancer patients. We compared a home-based graduated walking intervention with a fixed walking recommendation.recommendation to exercise to determine the effects of these interventions during adjuvant radiotherapy (RT) on older women with breast cancer. A randomized phase 2 trial in women ≥65 years, with stage 0–3 breast cancer. Prior to initiating breast RT, women were randomized to a Home-Based Graduated Walking Program (HBGWP) or a fixed walking recommendation. The primary outcome of fatigue was measured by the Total Disruption Index (TDI) of the Fatigue Symptom Inventory (FSI). Secondary outcomes including a short physical performance battery (SPPB) and questionnaires on exercise, physical function, fatigue (PROMIS Fatigue), and fatigue-related symptoms were collected at 3 time points. The primary goal was to compare the change in TDI between arms at the end of RT. Random coefficients models were used to determine the association between arm, fatigue, and exercise over time. Linear regression models were used to describe the change in outcome variables between visits. Median age of the 54 participants (27 per arm) was 69 years (range 65–84). The baseline characteristics were similar between study arms. The number of minutes walking per week increased in both arms (mean 21 min/wk. baseline to 83 min/wk. end of RT, p