Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Does physical activity improve chemotherapy completion in women receiving chemotherapy for ovarian cancer? (#79)

Vanessa L Beesley 1 , Tanya L Ross 1 , Nina (Renhua) Na 1 , Tharani Sivakumaran 2 , George Au-Yeung 2 , Christina M Nagle 1 3 , Anna deFazio 4 5 , Peter Grant 6 , Andreas Obermair 7 , Michael Friedlander 8 , Penelope Webb 1 3
  1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
  2. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  3. School of Public Health, The University of Queensland, Brisbane, QLD, Australia
  4. The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
  5. Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
  6. Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, VIC, Australia
  7. Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
  8. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia

Background: Ovarian cancer has a 5-year survival rate of <45%. Better overall survival has been shown for women who are able to complete a greater proportion of their planned chemotherapy. Physical activity during chemotherapy may reduce treatment-related side-effects enabling patients to better tolerate chemotherapy and avoid dose delays or reductions. We aimed to evaluate if physical activity during chemotherapy or changes in physical activity from pre-to-post diagnosis were associated with improved chemotherapy completion rates.

Methods: Women in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study who received ≥3 cycles of carboplatin and paclitaxel first-line chemotherapy and completed the Active Australia Survey during chemotherapy were included in this analysis (n=334). Planned chemotherapy, and dose reductions or delays were abstracted from clinical records. Women were asked about time spent in various types of physical activity in the years before their cancer diagnosis (at baseline) and in the past week (during chemotherapy). We classified physical activity during chemotherapy into tertiles of metabolic equivalent of task (MET) minutes and change from pre-diagnosis into largest decrease (n=107), smaller decrease (n=107) and no change (±90 MET-minutes/week) or increase (n=84). The associations of physical activity with chemotherapy completion (relative dose intensity (RDI) ≥85%) were assessed using logistic regression, with minimal sufficient adjustment informed by a directed acyclic graph.

Results: Overall 44% of women received ≥85% RDI. We found no association between level of physical activity during chemotherapy and chemotherapy completion (odds ratio [OR]=1.1; 95% confidence interval [CI]=0.6-1.8 for highest versus lowest tertile). However compared to women with the largest decrease from pre-diagnosis, women who maintained or increased their physical activity were significantly more likely to complete chemotherapy (RDI ≥85%) (OR=2.2; 95%CI=1.2-4.0).  

Conclusions: Supporting women to maintain their pre-existing level of physical activity during chemotherapy for ovarian cancer may improve chemotherapy completion and in turn overall survival.