BACKGROUND:Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life. METHODS/DESIGN:Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression. DISCUSSION:The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated. TRIAL REGISTRATION:NCT02473003 , October, 2014.

译文

背景:与癌症相关的疲劳是癌症患者中的常见问题,影响与健康相关的生活质量并给社会带来巨大挑战。目前的证据支持体育锻炼对减轻疲劳的有益作用,但研究结果不一致,尤其是在运动强度方面。还不清楚使用行为改变技术是否可以进一步增加运动依从性并保持体育锻炼行为。这项研究将调查运动强度是否会影响接受辅助癌症治疗的人的疲劳和与健康相关的生活质量。此外,研究运动强度对情绪紊乱,对肿瘤治疗的依从性,治疗的不良影响,治疗完成后和恢复工作后的日常生活活动以及行为改变技术对运动依从性的影响。我们还将调查运动强度是否会影响炎症标志物和细胞因子,以及训练后的基因表达是否充当运动对疲劳和健康相关生活质量的影响的中介物。
方法/设计:将对接受辅助治疗的600名新诊断的乳腺癌,结肠直肠癌或前列腺癌患者按照2×2因子设计随机分配至以下情况; A)有或没有行为改变技术的量身定制的中低强度运动,或B)有或没有行为改变技术的量身定制的高强度运动。训练包括在训练有素的教练的指导下进行的抵抗力和耐力运动。主要结果是疲劳和健康相关的生活质量,是通过自我报告来衡量的。次要结果包括健康状况,情绪紊乱,对癌症治疗的依从性,不良反应,完成治疗后恢复日常生活活动,恢复工作以及炎症标志物,细胞因子和基因表达。
讨论:这项研究将有助于我们了解运动价值和运动强度,以减轻疲劳和改善健康相关的生活质量,并可能改善临床结果。将评估行为改变技术对癌症患者坚持和维持体育锻炼行为的价值。
试用注册:NCT02473003,2014年10月。

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