PMID- 37026453
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20240110
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Print)
IS  - 0003-4932 (Linking)
VI  - 278
IP  - 1
DP  - 2023 Jul 1
TI  - Effects of a Pragmatic Home-based Exercise Program Concurrent With Neoadjuvant 
      Therapy on Physical Function of Patients With Pancreatic Cancer: The PancFit 
      Randomized Clinical Trial.
PG  - 22-30
LID - 10.1097/SLA.0000000000005878 [doi]
AB  - OBJECTIVE: To determine the effects of a preoperative, home-based exercise 
      program on fitness and physical function in patients with pancreatic cancer. 
      BACKGROUND: We previously established a well-tolerated preoperative exercise 
      program after finding a high frequency of sarcopenia and frailty in patients with 
      pancreatic cancer. METHODS: In this randomized, controlled trial (NCT03187951), 
      patients with pancreatic cancer were randomized to Arm A: enhanced usual care or 
      Arm B: prescribed aerobic and resistance exercise during neoadjuvant therapy. 
      Patients received nutrition counseling and activity trackers. The primary 
      endpoint was a 6-minute walk distance (6MWD; >/=14 meters improvement was 
      clinically meaningful). Secondary endpoints included additional physical function 
      tests, health-related quality of life, and clinical outcomes. RESULTS: One 
      hundred fifty-one patients were randomized. Objectively measured weekly activity 
      (153.2+/-135.6 and 159.8+/-122.8 min in Arm A and B, respectively, P =0.62) and 
      self-reported weekly moderate-to-strenuous physical activity (107.4+/-160.4 and 
      129.6+/-161.6 min in Arm A and Arm B, respectively, P =0.49) were similar, but 
      weekly strength training sessions increased more in Arm B (by 1.8+/-1.8 vs 0.1+/-2.4 
      sessions, P <0.001). 6MWD improved in both Arm A (mean change 18.6+/-56.8 m, P 
      =0.01) and Arm B (27.3+/-68.1 m, P =0.002). Quality of life and clinical outcomes 
      did not significantly differ between arms. Pooling patients in both study groups, 
      exercise, and physical activity was favorably associated with physical 
      performance and clinical outcomes. CONCLUSIONS: In this randomized trial of 
      prescribed exercise versus enhanced usual care during neoadjuvant therapy for 
      pancreatic cancer, a high volume of physical activity and increased exercise 
      capacity were observed in both arms, highlighting the importance of activity 
      among patients preparing for surgery.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Ngo-Huang, An T
AU  - Ngo-Huang AT
AUID- ORCID: 0000-0003-4797-4147
AD  - Department of Palliative, Rehabilitation, and Integrative Medicine, The 
      University of Texas MD Anderson Cancer Center, Houston, TX.
FAU - Parker, Nathan H
AU  - Parker NH
AD  - Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.
FAU - Xiao, Lianchun
AU  - Xiao L
AD  - Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Schadler, Keri L
AU  - Schadler KL
AD  - Department of Pediatrics, The University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Petzel, Maria Q B
AU  - Petzel MQB
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Prakash, Laura R
AU  - Prakash LR
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Kim, Michael P
AU  - Kim MP
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Tzeng, Ching-Wei D
AU  - Tzeng CD
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Lee, Jeffrey E
AU  - Lee JE
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Ikoma, Naruhiko
AU  - Ikoma N
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Wolff, Robert A
AU  - Wolff RA
AD  - Department of Gastrointestinal Medical Oncology, The University of Texas MD 
      Anderson Cancer Center, Houston, TX.
FAU - Javle, Milind M
AU  - Javle MM
AD  - Department of Gastrointestinal Medical Oncology, The University of Texas MD 
      Anderson Cancer Center, Houston, TX.
FAU - Koay, Eugene J
AU  - Koay EJ
AD  - Department of Gastrointestinal Radiation Oncology, The University of Texas MD 
      Anderson Cancer Center, Houston, TX.
FAU - Pant, Shubham D
AU  - Pant SD
AD  - Department of Gastrointestinal Medical Oncology, The University of Texas MD 
      Anderson Cancer Center, Houston, TX.
FAU - Folloder, Justin P
AU  - Folloder JP
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Wang, Xuemei
AU  - Wang X
AD  - Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Cotto, Alicia M
AU  - Cotto AM
AD  - Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.
FAU - Ju, Ye Rang
AU  - Ju YR
AD  - Department of Health Disparities Research, The University of Texas MD Anderson 
      Cancer Center, Houston, TX.
FAU - Garg, Naveen
AU  - Garg N
AD  - Department of Abdominal Imaging, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
FAU - Wang, Huamin
AU  - Wang H
AD  - Department of Pathology, The University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Bruera, Eduardo D
AU  - Bruera ED
AD  - Department of Palliative, Rehabilitation, and Integrative Medicine, The 
      University of Texas MD Anderson Cancer Center, Houston, TX.
FAU - Basen-Engquist, Karen M
AU  - Basen-Engquist KM
AD  - Department of Health Disparities Research, The University of Texas MD Anderson 
      Cancer Center, Houston, TX.
FAU - Katz, Matthew H G
AU  - Katz MHG
AD  - Department of Surgical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX.
LA  - eng
SI  - ClinicalTrials.gov/NCT03187951
GR  - P30 CA016672/CA/NCI NIH HHS/United States
GR  - R25 CA203650/CA/NCI NIH HHS/United States
GR  - R01 CA195651/CA/NCI NIH HHS/United States
GR  - P01 CA117969/CA/NCI NIH HHS/United States
GR  - R21 CA218732/CA/NCI NIH HHS/United States
GR  - R01 CA196941/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20230407
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
CIN - Ann Surg Open. 2023 Nov 08;4(4):e359. PMID: 38144485
MH  - Humans
MH  - *Quality of Life
MH  - Neoadjuvant Therapy
MH  - Exercise
MH  - Exercise Therapy
MH  - *Pancreatic Neoplasms/therapy
PMC - PMC10330108
MID - NIHMS1888682
COIS- The authors report no conflicts of interest.
EDAT- 2023/04/08 06:00
MHDA- 2023/06/12 06:42
PMCR- 2024/07/01
CRDT- 2023/04/07 05:02
PHST- 2024/07/01 00:00 [pmc-release]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2023/04/07 05:02 [entrez]
AID - 00000658-202307000-00006 [pii]
AID - 10.1097/SLA.0000000000005878 [doi]
PST - ppublish
SO  - Ann Surg. 2023 Jul 1;278(1):22-30. doi: 10.1097/SLA.0000000000005878. Epub 2023 
      Apr 7.