James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
James P. Wilmot Cancer Institute, Rochester, NY, USA.
J Geriatr Oncol. 2022 May;13(4):545-553. doi: 10.1016/j.jgo.2021.12.011. Epub 2021 Dec 21.
We have shown the Exercise for Cancer Patients (EXCAP) exercise program improved physical function and symptoms and reduced inflammatory markers in patients with cancer. However, adherence to exercise was lower in older adults compared to their younger counterparts. We then leveraged a mobile app to deliver EXCAP and adapted the intervention [Geriatric-Oncology (GO)-EXCAP] for older patients with myeloid neoplasms. In this pilot randomized trial, the primary goal is to determine effect sizes. We propose to assess the preliminary efficacy of GO-EXCAP compared to a behavioral placebo control on physical function, patient-reported outcomes (fatigue, mood, and quality of life), and inflammatory markers in 100 patients aged ≥60 years with myeloid neoplasms receiving outpatient chemotherapy.
GO-EXCAP consists of the EXCAP exercise prescription (daily home-based progressive aerobic walking and resistance exercises with rated perceived exercise of 5-8), EXCAP kit (i.e., activity tracker, resistance bands, print manual, bag), a mobile app, and an in-person or virtual session with the exercise physiologist to deliver exercise prescription. The intervention will last for three cycles of chemotherapy (approximately 12 weeks). The primary outcome measure will be physical function (Short Physical Performance Battery). Secondary outcome measures include fatigue (Brief Fatigue Inventory), mood (Center for Epidemiologic Studies Depression Scale), and quality of life (Functional Assessment of Cancer Therapy-Leukemia). Exploratory outcome measures include inflammatory markers.
Older adults with myeloid neoplasms receiving outpatient chemotherapy serve as an ideal model for studying an individually tailored mobile health exercise intervention in vulnerable older patients receiving cancer treatments to prevent physical function decline and improve symptoms.
我们已经证明，“癌症患者运动”（EXCAP）锻炼计划可以改善癌症患者的身体功能和症状，并降低炎症标志物。然而，与年轻人相比，老年人的锻炼依从性较低。因此，我们利用移动应用程序来提供 EXCAP，并为患有骨髓增生性肿瘤的老年患者改编了干预措施[老年肿瘤学（GO）-EXCAP]。在这项初步的随机试验中，主要目标是确定效果大小。我们建议评估 GO-EXCAP 与行为安慰剂对照在 100 名年龄≥60 岁的接受门诊化疗的骨髓增生性肿瘤患者中的身体功能、患者报告的结果（疲劳、情绪和生活质量）和炎症标志物方面的初步疗效。
GO-EXCAP 包括 EXCAP 运动处方（每天在家进行渐进性有氧运动和阻力运动，感知运动强度为 5-8）、EXCAP 工具包（即活动追踪器、阻力带、印刷手册、包）、移动应用程序以及与运动生理学家进行的面对面或虚拟会话，以提供运动处方。干预将持续三个化疗周期（大约 12 周）。主要结局指标将是身体功能（简短身体表现电池）。次要结局指标包括疲劳（简要疲劳量表）、情绪（流行病学研究抑郁量表）和生活质量（癌症治疗-白血病功能性评估）。探索性结局指标包括炎症标志物。
接受门诊化疗的骨髓增生性肿瘤老年患者是研究针对接受癌症治疗的脆弱老年患者的个性化移动健康锻炼干预措施的理想模型，以预防身体功能下降和改善症状。
