Exercise Reduces Severity of Chemotherapy-Induced Peripheral Neuropathy

A groups of seniors stretches before excerise.
A groups of seniors stretches before excerise.
For this study, researchers sought to determine the effect exercise would have on severity of symptoms for patients who develop CIPN after taxane, platinum, or vinca alkaloid based chemotherapy.

Patients with cancer who experience chemotherapy-induced peripheral neuropathy (CIPN) may experience improvement with exercise, according to a study published in Supportive Care in Cancer.

CIPN is a commonly occurring morbidity associated with cancer therapy; approximately 50% of patients who receive taxane, platinum, or vinca-alkaloid–based chemotherapy experience peripheral neuropathy, but effective therapeutic options are limited.

For this study, researchers evaluated the outcomes of 456 patients with cancer treated with CIPN-inducing chemotherapy regimens. Patients were randomly assigned to receive either chemotherapy or chemotherapy plus the Exercise for Cancer Patients (EXCAP) program, in which patients undergo moderate-intensity walking and resistance exercises for 6 weeks. All patients reported CIPN symptoms preintervention and postintervention.

Of the 456 patients enrolled, 355 completed both intervention assessments and were eligible for evaluation. Reasons for study drop-out included feeling overwhelmed, experienced some medical issue, or no reasons were given. Exercise-arm assignment, limited education, older age, and greater baseline fatigue were factors found to be significantly associated with study incompletion upon multivariate analysis.

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After 6 weeks of chemotherapy, CIPN severity unexpectedly worsened compared with baseline reports, but to a lesser extent among patients assigned to the exercise arm. Analysis showed that the increases in CIPN symptoms of hot/coldness in hands/feet and numbness/tingling were lower by .46 units (P =.045) and 0.42 units (P =.076), respectively, among patients in the exercise arm compared with the control arm.

Patients who were older (P =.086), male (P =.028), and had breast cancer (P =.076) experienced greatest reduction of symptoms with exercise.  

The authors concluded that exercise “is a promising tool that clinicians should consider prescribing for patients receiving taxane-based, platinum-based, and vinca alkaloid-based drugs, especially for geriatric patients.

Reference

Kleckner IR, Kamen C, Gewandter JS, et al. Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial [published online December 14, 2017]. Supp Care Cancer. doi: 10.1007/s00520-017-4013-0