Author (date) | Study type | Diagnosis | Age (y) | Treatment | Intervention | Control/ comparison | Outcomes | Results |
---|---|---|---|---|---|---|---|---|
Banzer et al. (2014) | Single-arm prospective | Stage I-IV pancreatic cancer (n = 3) | Range: 54–65 years | Adjuvant chemotherapy w/ Gemcitabine | Home-based aerobic exercise | N/A | Measured pre and post intervention Aerobic capacity (CPET-VO2peak) Quality of life (EORTC) Fatigue (EORTC Fatigue symptom subscale) | VO2peak Participant 1: + 5.7 ml/kg/min− 1 Participant 2: + 8.7 ml/kg/min− 1 Participant 3: − 3.2 ml/kg/min− 1 Quality of life (point change score) Participant 1: 0 Participant 2: + 25 Participant 3: + 17 Fatigue symptom scale Participant 1: + 22 Participant 2: + 11 Participant 3: + 11 |
Cormie et al. (2014) | Case report | invasive colloid adenocarcinoma T2 N1 M0 stage IIb | 49 years | Surgery > adjuvant chemotherapy and radiotherapy | Supervised exercise (aerobic /resistance exercise) 3 months post-surgery | N/A | Measures at baseline, 3, 6 months 400 m walk, 1RM leg press, 5xSTS, stair climb, usual / fast paced − 6 m walk, static balance Body composition, BMD (DXA) PA levels (GLTEQ) Quality of life (SF-36, FACT-Hep) Fatigue (FACT-fatigue) | Adherence: 35 / 48 sessions completed (73%) Change from baseline- 400 m walk time (s) at 3 months: − 5.9%, at 6 months: − 17.5% Leg press 1RM (kg) 3 months: + 31.6%, 6 months: + 42.1% 5xSTS (s) 3 months: − 17.2%, 6 months: − 28.2% Stair climb (s) 3 months: − 9.9%, 6 months: − 19.1% Whole body lean mass (kg) 3 months: + 2.9%, 6 months + 3.3% Appendicular lean mass (kg) 3 months: + 3.4%, 6 months: + 8.2% Lumbar spine BMD (g.cm− 2) 3 months: − 0.5%, 6 months: + 0.4% Quality of life: S-36 Improved subscales at 3 months: range 19–61%, 6 months: 34–150% FACT-Hep improved subscales at 3 months: range 20–109%, 6 months: 15–127% Fatigue Improved at 3 months: 350%, 6 months: 488% |
Marker et al. (2018) | Case series | Recently diagnosed (< 4 weeks) borderline-resectable pancreatic adenocarcinoma (n = 3) | Range: 70–74 years | Neo-adjuvant chemotherapy | Supervised, tailored exercise (aerobic/resistance/flexibility) for duration of neo-adjuvant therapy | No control | Measures at baseline, 2 wks preoperatively, 6wks post discharge (* participant 3 received no surgery, post intervention only) Body composition, 400 m walk, fast gait speed, usual gait speed, 30STS, HGS, stair climb Quality of life (FACT-G) Fatigue (FACIT-F) | Lean body mass change from baseline, Participant 1: at pre-op + 15%, at follow-up + 3 Participant 2: at pre-op + 1%, at follow-up − 6% *Participant 3: post intervention + 4% 400-m walk Participant 1: at pre-op + 11%, follow up + 8% Participant 2: pre-op − 4%, follow up 0% Participant 3: post intervention + 11% USG Participant 1: pre-op − 8%, follow-up 0% Participant 2: pre-op + 7%, follow-up + 13% Participant 3: post intervention − 6% FSG Participant 1: pre-op 0%, follow-up 0% Participant 2: pre-op + 4%, follow-up − 22% Participant 3: post intervention + 9% Stair climb Participant 1: pre-op − 11%, follow-up − 14% Participant 2: pre-op − 21%, follow-up − 28% Participant 3: post intervention + 5% HGS Participant 1: pre-op + 3% (D), − 8% (ND), follow-up − 2% (D) -1% (ND) Participant 2: pre-op + 2% (D), − 7% (ND), follow-up − 12% (D), − 23% (ND) Participant 3: post intervention − 1% (D), − 4% (ND) 30STS Participant 1: pre-op + 54, follow up + 8% Participant 2: pre-op + 44% follow-up + 11 Participant 3: post intervention 0% |
McLaughlin et al. (2019) | Case report | locally advanced pancreatic adenocarcinoma with invasion of the superior mesenteric vein stage III | 47 | Adjuvant chemotherapy w/ Folfirinox | Supervised exercise (aerobic/resistance exercise) | N/A | Measured at baseline, 4, 8, 12-week Aerobic capacity (estimated VO2max) Lower / upper body strength (12-RM) Flexibility: seated toe-reach Function: 5xSTS, usual/fast/backwards 6-m walk Body composition (BIA) Quality of life (FACT-Hep) Fatigue (FACIT-fatigue) | Adherence 94% (15/16) Results reported as improvement from baseline at 4, 8, 12 weeks, but not explicitly stated. Figures are estimated from study graphs Estimated VO2max: + 6%, + 8%, + 8% All strength measures improved from baseline at each time point Flexibility: not reported 5xSTS: + 2%, + 17%, + 8% 6-m walk: + 17%, + 7%, + 15% Body composition reported as change from baseline to 12 weeks Body fat % -4.4 Lean mass % + 4.3 Quality of life: + 42%, + 40%, + 38% Fatigue: + 78%, + 84%, + 114% |
Mouri et al. (2018) | Single-arm prospective | Stage III and IV pancreatic cancer (n = 6) | 74 ± 3 | gemcitabine plus nab-paclitaxel | Home-based resistance training | No control | Quality of life (EORTC) | Global QOL score: T1–56 ± 37, T2–60 ± 32, T3–55 ± 34 Physical subscale QoL: T1–82 ± 21, T2–85 ± 20, T3–75 ± 28 |
Naito et al. (2018) | Single-arm prospective | Stage III and IV pancreatic cancer (n = 6) | 74 ± 3 | gemcitabine plus nab-paclitaxel | Home-based resistance training | No control | 6 min walk test 5 m gait speed 5xSTS Hand grip strength | 6MWT: T1–459 ± 56 m, T2 – N/R, T3–477 ± 51 m 5 m gait speed: T1–1.2 ± 0.2 m/s, T2 – N/R, T3–1.1 ± 0.3 m/s 5xSTS: T1–11 ± 1, T2–10 ± 3, T3–13 ± 10 Hand grip strength: T1–23.7 ± 4.3 kg, T2–24.0 ± 5.1 kg, T3–22.3 ± 4.6 kg |
Ngo-Huang et al. (2017) | Single-arm prospective | Resectable pancreatic adenocarcinoma (n = 15) | Mean: 66 ± 6 | Chemotherapy and/or chemoradiation | Pre-operative aerobic and resistance exercise (home-based, unsupervised) | No control | Measures at baseline (n = 20), 1-week pre-surgery (n = 15), 4 weeks post-surgery Primary outcome: Adherence-Self-report exercise minutes (IPAQ) Secondary outcomes: 10-m walk Dynamic gait index (Balance) 5 x STS (strength) Self-report physical function (PROMIS-sf) | 12/15 met aerobic exercise recommendation 6/15 met resistance exercise recommendation 11/15 met or exceeded weekly exercise recommendation (120mins) Pre-operative: 98.6 ± 69.8 mins (aerobic), 57.4 ± 36 min (resistance) Mean: 156.0 ± 64.5 weekly total exercise During chemoradiation aerobic (128.6 ± 106 vs 48.0 ± 35.3 resistance, p = .04 PROMIS declined baseline to post-operative p = .03 Grip strength decline pre-op to post op, p = .03 No other changes in secondary measures |
Ngo-Huang et al. (2019) | Single-arm prospective | Resectable pancreatic adenocarcinoma (n = 45) | Mean: 66 ± 8 | Surgery + neo-adjuvant chemo-radiotherapy | Pre-operative aerobic and resistance exercise (home-based, unsupervised) | No control | Measures at baseline and follow-up 6MWT, 5xSTS, HGS, 3-m walk FACT-Hep, FACT-G | 48% underwent curative surgery Change form baseline to follow-up 6MWT + 26 m, p = .001 5xSTS 0.8 s, p = .049 3-m walk + 0.5 m.s, p = .009 No change in HGS, p = .90 No significant changes in QoL outcomes, p = .09 |
Niels et al. (2018) | Case report | Stage IV pancreatic carcinoma in tail (peritoneal metastases) | 46 yr old | Palliative, neo-adjuvant, surgery, adjuvant | Supervised concurrent exercise | N/A | Measures at baseline, 3 months and 7 months Leg extension, curl, chest press, row, back extension, ab crunch, 30/15 W cross walker and bicycle test EORTC, HADS Physical activity levels (GPAQ) | Progressed - palliative therapy > neo-adjuvant therapy >surgery > adjuvant Body weight maintained during neo-adjuvant chemotherapy. All functional outcomes improved at 3 months Performed watt + 39% endurance exercise Seated row + 9 Leg extension + 79% Chest press + 38% Global QoL + 16.6% All functional outcomes improved at 7 months, with the exception of: Abdominal crunch − 88.4% Leg curl − 3.6% |
Stiendorf et al. (2019) | 3 arm RCT | Resectable or non-resectable PDAC (I-IV) (n = 47) | Mean: 60.5 ± 8.4 | neo-adjuvant chemotherapy | Home-based RT and/vs supervised RT | Usual care | Measures: baseline (n = 65), 3 months (n = 55), 6 months (n = 47) Quality of life (EORTC + PAN26 module) Fatigue (MFI) | No change in quality of life or fatigue outcomes at 6 months When resistance exercise groups pooled, mean group difference at 3 months for Global quality of life (p = 0.016), physical functioning (p = 0.016), cognitive functioning (p = 0.008) and sleep problems (p = 0.016) were all significantly different. Similar results reported for Physical fatigue subscale (p = 0.019), reduced activity (p = 0.018) and reduced motivation (p = 0.028) |
Wiskemann et al. (2019) | 3 arm RCT | Resectable or non-resectable PDAC (I-IV) (n = 43) | Supervised: 62.8 (6.4) Home-based: 61.1 (8.7) UC: 57.8 (8.2) | neo-adjuvant chemotherapy | Home-based RT and/vs supervised RT | Usual care | Measures at: baseline (n = 65) 6 months (n = 43) Adherence (self-report logs) Strength (isokinetic), HGS CPET, 6MWT, | Mean overall adherence was 59.2% MIPT: RT1 vs CON elbow flexors (p = 0.02) extensors (p = 0.01) but not lower limb. RT1 vs RT2 elbow flexors and extensor (p < 0.05) MVIC: RT1 vs CON elbow flexors (p = 0.02) knee extensors (p = 0.01). RT2 vs CON knee extensors (p = 0.05 RT1 vs RT2 no difference CPET: RT1 vs CON / RT2 peak work rate (both p < 0.05) VO2peak (L/min) RT1 vs RT2 p > 0.05, RT1 vs CON, p > 0.05, RT2 vs CON, p > 0.05 Body weight: + 3.2% RT1, − 0.4% RT2. Weight loss > 5% observed in n = 14 over intervention |
Yeo et al. (2012) | 2 arm prospective RCT (n = 102) | Resected pancreatic and periampullary cancer (n = 102) | Mean: IG: 66 (38–87) UCG: 67 (48–91) | Adjuvant chemotherapy | Home-based walking | Usual care | Measures: baseline, post intervention (3–6 months) Fatigue (FACIT) Pain (VAS) Observed walk (distance / time) Self-report diary (monthly) General health (SF-36v2) ECOG | Walking distance; IG 2 miles, vs 1 mile UCG (p = 0.1) IG sig more likely to be walking / active (80 v 58%, p = 0.04) At baseline, mod-severe fatigue in 85% of participants Baseline fatigue not different between groups (mean 27 vs 30). At POST, IG group fatigue better (p = 0.05) Pain (mild in both groups at baseline, VAS = 2.9). improved in both groups POST (1.6 & 1.8) ECOG scores fell in IG (1.6–1.5), increased in UCG (1.5–1.8) SF-36 health survey, 6 of 8 domains improved in IG, 4 of 8 UCG Mental and physical components both improved IG, MCS in UCG |