Effects of 6-Month Exercise Training on Quality of Life in Pancreatic Cancer Patients: Results from a Randomized Controlled Trial

Background: Given the poor prognosis and high symptom burden of pancreatic cancer, preservation of quality of life (QoL), physical functioning and minimization of adverse treatment effects are important treatment goals in pancreatic cancer patients. Even though exercise has proven to provide health benefits, including improvements in QoL, in patients with various cancer types, studies are rare for more aggressive cancer types like pancreatic cancer. Therefore, we conducted a randomized controlled trial to assess the efficacy of a 6-month resistance training (RT) on QoL in pancreatic cancer patients. Methods: Sixty-five pancreatic cancer patients, mostly stage IIb after tumor resection and during chemotherapy, were assigned to one of two progressive RT groups (supervised or home-based) or to usual care for 6 months. The primary outcome, the physical functioning subscale of the EORTC QLQ-C30, and other QoL-related outcomes were assessed before the intervention, after 3 and 6 months. Results: Forty-seven patients (mean age: 60.5 years, 53.2% males) completed the intervention period. After 6 months, no between-group differences were observed. However, after 3 months, intention-to-treat analyses showed significant between-group mean differences (MD) in favor for the pooled RT group for physical functioning (MD = 12.0; p = 0.010), as well as for overall QoL (MD = 12.5; p = 0.014), and several other secondary outcomes (cognitive functioning, insomnia, physical fatigue, and reduced activity). Both modes of delivery, supervised and home-based resistance-training, showed similar effects. Overall mean training adherence rate was 66.5%, with a steady decrease over the 6-month intervention period. Conclusions: This was the first randomized controlled RT intervention trial in pancreatic cancer patients. The findings showed clinically relevant improvements in QoL after 3 but not 6 months. Given the severity of pancreatic cancer and the importance of maintaining QoL, patients should be timely advised to perform exercise. Future research needs to focus on prolonging the positive mid-term effects, possibly through improving training adherence. Clinical trial identification: NCT01977066. Legal entity responsible for the study: German Cancer Research Center. Funding: German Cancer Aid (Foundation). Disclosure: All authors have declared no conflicts of interest.