Author(s): IMPERIO, M.1, ANNIBALINI, G.1, DE SANTI, M.1, LUCERTINI, F.1, VALLORANI, L.1, NATALUCCI, V.2, FERRI MARINI, C.3, MICHELI, L.1, GROSSI, T.1, SALTARELLI, R.1, VILLARINI, A.4, STOCCHI, V.5, CATALANO, V.6, GUARINO, S.6, BAROCCI, S.6, FLORI, M.6, SISTI, D.1, ROCCHI, M.B.L.1, EMILI, R.6, BARBIERI, E.1, Institution: UNIVERSITY OF URBINO CARLO BO, Country: ITALY, Abstract-ID: 1509

INTRODUCTION:
Anti-cancer treatment, unbalanced diet, and sedentary behavior affect the quality of life (QoL) of Breast Cancer survivors (BCS). By contrast, being physically active and following a healthy diet represent an effective strategy to improve QoL and cardiometabolic health. This study aimed to evaluate the effect of lifestyle intervention (LI) combining structured aerobic exercise and Mediterranean diet (MD) guidance on i) QoL and ii) cardiometabolic health in BCS.
METHODS:
One hundred and nine (n=109) BCS (age 51.7±8.0 years) from the Movis RCT [1] (NCT04818359) were randomized to either an intervention group [IG] (n=53) performing a 12-week supervised aerobic training program plus receiving MD and physical activity (PA) recommendations or a control group [CG] (n=56), receiving PA and MD recommendations only. The IG participants were trained 3 times per week with progressive increases in exercise intensity (40-70% of heart rate reserve) and duration (20-60 minutes) over 12 weeks. QoL was evaluated using the cancer-specific EORTCQLQ-C30 [2] questionnaire. Cardiometabolic health was assessed by measuring cardiorespiratory fitness (V̇O2max [mL·min-1·kg-1]) and MD adherence (Mediet questionnaire). Assessments were performed before (T0) and after (T1) the LI, and at 6 (T2), 12 (T3), and 24 (T4) months of follow-up. Linear mixed models, adjusted for age and endocrine therapy type, were used to assess group-by-time effects (α=0.05).
RESULTS:
Physical (β=3.620, p=0.024) and social (β=6.809, p=0.033) functioning, QLQ-C30 summary score (β=2.948, p=0.048), and V̇O2max (β=2.104, p=0.007) increased significantly at T1 in the IG compared to the CG, however they tended to baseline values at T2, T3, and T4 with no differences between groups. Fatigue decreased by 5 points (minimal clinically important difference) in the IG at T1 but returned to baseline thereafter. No significant differences were found in other EORTCQLQ-C30 scales. Interestingly, for each 1-year increase in age, BCS experienced significantly less nausea and vomiting (β=-0.149, p=0.014) and diarrhea (β=-0.228, p=0.036). BCS who were treated with Tamoxifen experienced significantly more insomnia (β=12.35, p=0.026) and appetite loss (β=4.852, p=0.009) compared to BCS with no endocrine therapy. MD adherence increased significantly in both groups at T1 (β=0.679, p=0.010) and remained higher until T3 (β=0.622, p=0.023).
CONCLUSION:
LI significantly improved QoL and cardiorespiratory fitness in BCS in the short term. However, without continued supervision, these benefits tended to diminish over time, whereas improvements in MD adherence were maintained in both groups. Age and Tamoxifen therapy influenced specific symptoms (e.g., diarrhea or appetite loss). These findings highlight the importance of long-term educational and support strategies to promote sustained healthy behaviours in BCS.
[1] Natalucci V. et al. Trials, 2023.
[2] Aaronson, N.K. et al. J. Natl. Cancer Inst., 1993.