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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT02846389
Other study ID # Pro2016-0162
Secondary ID
Status Active, not recruiting
Phase N/A
First received
Last updated
Start date June 21, 2016
Est. completion date May 2026

Study information

Verified date September 2022
Source Hackensack Meridian Health
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Like other cancer treatments, radiation therapy can make people feel fatigued, or tired. The investigators think that moderate exercise, done 15 minutes at a time, can reduce the fatigue. This study is designed to gather more information, so that in the future, doctors can recommend whether patients should engage in exercise during a radiation treatment course.


Description:

Cancer related fatigue (CRF) is a common and debilitating side effect of radiotherapy in breast cancer patients. Physical activity interventions can attenuate CRF. The proposed study is a randomized, controlled trial (RCT) of exercise of structured moderate-intensity exercise intervention, delivered concurrently with radiotherapy, to reduce CRF and improve health-related quality of life among breast cancer patients. Eighty women with breast cancer scheduled to receive radiation therapy at Hackensack University Medical Center (HUMC) will be randomized to one of the two trial arms:1) a facility-based aerobic exercise utilizing a portable stationary pedal exerciser; or 2) a control group. Intervention arm participants will exercise at the hospital either before or after their radiation treatment. Assessments will be conducted at baseline, 4 weeks into radiation course, and at 4-week follow-up visit. The outcome variables are CRF, biomarkers of inflammation, and health-related quality of life (QOL). The study will provide preliminary evidence on whether a short-term moderate-intensity exercise intervention might be effective in reducing CRF in women undergoing radiotherapy for breast cancer, and whether this effect is mediated by inflammation.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 24
Est. completion date May 2026
Est. primary completion date May 2026
Accepts healthy volunteers No
Gender Female
Age group 18 Years to 75 Years
Eligibility Inclusion Criteria: 1. women between the ages of 18 and 75 years 2. histologically confirmed non-metastatic carcinoma of the breast (in situ disease or invasive) 3. radiation therapy naïve 4. sedentary activity level at baseline, as defined by less than 60 minutes per week of modest physical activity based on 7-day physical activity recall questionnaire 5. ambulatory 6. negative serum pregnancy test and not planning to become pregnant in the next three months 7. able to provide meaningful consent. 8. Patients must have been deemed by their medical oncologist or internist that they "may participate in [this] exercise trial." Prior to randomization, participants are required to complete a Physical Activity Readiness Questionnaire (PAR-Q) that includes questions regarding physical and medical conditions that would preclude safe participation in an exercise program. Exclusion Criteria: 1. younger than 18 or older than 75 years 2. no histological confirmation of breast cancer 3. prior breast, chest, or pelvic radiotherapy 4. concurrent chemotherapy 5. distant metastases 6. physical limitations that contraindicate participation in low to moderate intensity exercise 7. positive pregnancy test 8. currently engaged in moderate to vigorous physical activity 9. psychiatric disorder which would render the participant unable to provide informed consent.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Moderate Exercise
Aerobic training utilizing the portable stationary pedal exerciser (Pedlar) which contains two cycling pedals mounted to a stationary block that allows patients to exercise while sitting. Participants are required to perform 15 minutes/day of aerobic exercise using the Pedlar device on radiation treatment days; during a standard radiation course, this will typically yield 75 minutes/week of aerobic time.

Locations

Country Name City State
United States Hackensack University Medical Center Hackensack New Jersey

Sponsors (2)

Lead Sponsor Collaborator
Hackensack Meridian Health Lombardi Comprehensive Cancer Center

Country where clinical trial is conducted

United States, 

References & Publications (34)

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Bower JE, Ganz PA, Tao ML, Hu W, Belin TR, Sepah S, Cole S, Aziz N. Inflammatory biomarkers and fatigue during radiation therapy for breast and prostate cancer. Clin Cancer Res. 2009 Sep 1;15(17):5534-40. doi: 10.1158/1078-0432.CCR-08-2584. Epub 2009 Aug 25. — View Citation

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Christiansen H, Saile B, Hermann RM, Rave-Fränk M, Hille A, Schmidberger H, Hess CF, Ramadori G. Increase of hepcidin plasma and urine levels is associated with acute proctitis and changes in hemoglobin levels in primary radiotherapy for prostate cancer. J Cancer Res Clin Oncol. 2007 May;133(5):297-304. Epub 2006 Nov 25. — View Citation

Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003 May 1;21(9):1660-8. — View Citation

Cuesta-Vargas AI, Buchan J, Arroyo-Morales M. A multimodal physiotherapy programme plus deep water running for improving cancer-related fatigue and quality of life in breast cancer survivors. Eur J Cancer Care (Engl). 2014 Jan;23(1):15-21. doi: 10.1111/ecc.12114. Epub 2013 Aug 16. — View Citation

Dhruva A, Dodd M, Paul SM, Cooper BA, Lee K, West C, Aouizerat BE, Swift PS, Wara W, Miaskowski C. Trajectories of fatigue in patients with breast cancer before, during, and after radiation therapy. Cancer Nurs. 2010 May-Jun;33(3):201-12. doi: 10.1097/NCC.0b013e3181c75f2a. — View Citation

Fisher B, Dignam J, Wolmark N, Mamounas E, Costantino J, Poller W, Fisher ER, Wickerham DL, Deutsch M, Margolese R, Dimitrov N, Kavanah M. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol. 1998 Feb;16(2):441-52. — View Citation

Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med. 2002 Aug 22;347(8):567-75. — View Citation

Galanti G, Stefani L, Gensini G. Exercise as a prescription therapy for breast and colon cancer survivors. Int J Gen Med. 2013 Apr 16;6:245-51. doi: 10.2147/IJGM.S42720. Print 2013. — View Citation

Geinitz H, Zimmermann FB, Stoll P, Thamm R, Kaffenberger W, Ansorg K, Keller M, Busch R, van Beuningen D, Molls M. Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer. Int J Radiat Oncol Biol Phys. 2001 Nov 1;51(3):691-8. — View Citation

Greenberg DB, Gray JL, Mannix CM, Eisenthal S, Carey M. Treatment-related fatigue and serum interleukin-1 levels in patients during external beam irradiation for prostate cancer. J Pain Symptom Manage. 1993 May;8(4):196-200. — View Citation

Hickok JT, Roscoe JA, Morrow GR, Mustian K, Okunieff P, Bole CW. Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer. Cancer. 2005 Oct 15;104(8):1772-8. — View Citation

Hovdenak N, Fajardo LF, Hauer-Jensen M. Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. Int J Radiat Oncol Biol Phys. 2000 Nov 1;48(4):1111-7. — View Citation

Jereczek-Fossa BA, Marsiglia HR, Orecchia R. Radiotherapy-related fatigue. Crit Rev Oncol Hematol. 2002 Mar;41(3):317-25. Review. — View Citation

King AC, Taylor CB, Haskell WL. Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol. 1993 Jul;12(4):292-300. Erratum in: Health Psychol 1993 Sep;12(5):405. — View Citation

Larsen A, Bjørge B, Klementsen B, Helgeland L, Wentzel-Larsen T, Fagerhol MK, Hovdenak N, Dahl O. Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy. Acta Oncol. 2007;46(5):639-50. — View Citation

Lundh Hagelin C, Wengström Y, Fürst CJ. Patterns of fatigue related to advanced disease and radiotherapy in patients with cancer-a comparative cross-sectional study of fatigue intensity and characteristics. Support Care Cancer. 2009 May;17(5):519-26. doi: 10.1007/s00520-008-0502-5. Epub 2008 Sep 13. — View Citation

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Mock V, Frangakis C, Davidson NE, Ropka ME, Pickett M, Poniatowski B, Stewart KJ, Cameron L, Zawacki K, Podewils LJ, Cohen G, McCorkle R. Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology. 2005 Jun;14(6):464-77. — View Citation

Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, Zimmermann KP. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil. 2007 Nov;88(11):1416-22. — View Citation

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Mustian KM, Peppone L, Darling TV, Palesh O, Heckler CE, Morrow GR. A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial. J Support Oncol. 2009 Sep-Oct;7(5):158-67. — View Citation

Noal S, Levy C, Hardouin A, Rieux C, Heutte N, Ségura C, Collet F, Allouache D, Switsers O, Delcambre C, Delozier T, Henry-Amar M, Joly F. One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer. Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):795-803. doi: 10.1016/j.ijrobp.2010.06.037. Epub 2010 Oct 1. — View Citation

Potthoff K, Schmidt ME, Wiskemann J, Hof H, Klassen O, Habermann N, Beckhove P, Debus J, Ulrich CM, Steindorf K. Randomized controlled trial to evaluate the effects of progressive resistance training compared to progressive muscle relaxation in breast cancer patients undergoing adjuvant radiotherapy: the BEST study. BMC Cancer. 2013 Mar 28;13:162. doi: 10.1186/1471-2407-13-162. — View Citation

Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer-related fatigue. Oncologist. 2007;12 Suppl 1:22-34. Review. — View Citation

Saligan LN, Kim HS. A systematic review of the association between immunogenomic markers and cancer-related fatigue. Brain Behav Immun. 2012 Aug;26(6):830-48. doi: 10.1016/j.bbi.2012.05.004. Epub 2012 May 14. Review. — View Citation

Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol A Biol Sci Med Sci. 1997 Jan;52(1):M27-35. — View Citation

Steindorf K, Schmidt ME, Klassen O, Ulrich CM, Oelmann J, Habermann N, Beckhove P, Owen R, Debus J, Wiskemann J, Potthoff K. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol. 2014 Nov;25(11):2237-2243. doi: 10.1093/annonc/mdu374. Epub 2014 Aug 5. — View Citation

Symon Z, Goldshmidt Y, Picard O, Yavzori M, Ben-Horin S, Alezra D, Barshack I, Chowers Y. A murine model for the study of molecular pathogenesis of radiation proctitis. Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):242-50. doi: 10.1016/j.ijrobp.2009.07.1736. — View Citation

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* Note: There are 34 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Assessment of change in fatigue via Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue) survey instrument. The FACIT is a 13-item subscale developed to identify a finite set of concerns specific to fatigue. The responses to the 13 items on the FACIT-Fatigue questionnaire are each measured on a 4-point likert scale, with score ranging from 0 to 52. The FACIT-Fatigue scale has been validated in patients with cancer and showed excellent internal consistency and reliability. Baseline, 4 weeks into RT, 4 week follow up visit
Primary Assessment of change in blood biomarker of inflammation: High sensitivity CRP (hsCRP) Serum hsCRP will be measured on the Vitros 5,1 FS Chemistry platform via an immunoassay with a reportable range of 0.10 -15.00 mg/L, and intra- and inter-assay CVs of 1.8-4.0%. Baseline, 4 weeks into RT, 4 week follow up visit
Primary Assessment of change in blood biomarker of inflammation: Serum fibrinogen Fibrinogen will be measured using standardized clinical protocols. All assays have intra- and inter-assays coefficient of variations <10%. Baseline, 4 weeks into RT, 4 week follow up visit
Primary Assessment of change in blood biomarker of inflammation: Ferritin Ferritin will be measured using standardized clinical protocols. All assays have intra- and inter-assays coefficient of variations <10%. Baseline, 4 weeks into RT, 4 week follow up visit
Primary Complete blood count data (CBC) We will collect CBC data at each blood draw for correlative and explorative purposes. Baseline, 4 weeks into RT, 4 week follow up visit
Secondary Assessment of change in Cancer-related healthcare quality of life (HRQOL) measured using the Functional Assessment of Cancer Therapy (FACT) system questionnaires. The HRQOL measures four different domains (physical well-being, functional well-being, emotional well-being, and social/family well-being). FACT-B is a breast cancer specific module that will be used to reflect patients' concerns; moreover, they are reliable, reproducible, and have been validated in numerous studies. Baseline, 4 weeks into RT, 4 week follow up visit
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