Author(s): CIURNELLI, C., BORSATI, A., ADAMOLI, G., GIORGETTI, A., TREVISAN, A., BELLUOMINI, L., INSOLDA, J., TRESTINI, I., TREGNAGO, D., MILELLA, M., SCHENA, F., PILOTTO, S., AVANCINI, A., Institution: UNIVERSITY , Country: ITALY, Abstract-ID: 2194

INTRODUCTION:
Cancer associated cachexia is a multifactor syndrome characterized by progressive loss of weight, skeletal muscle mass, and commonly associated with advanced and gastrointestinal cancers. To date, no effective treatment are currently available; exercise has a strong rationale for potentially managing the loss of muscle mass, the progressive functional decline and improve quality of life (QoL), typically observed in the context of cachexia. Nevertheless, the evidence are still limited. This study aims to investigate the feasibility and the impact of structured exercise on physical fitness, body composition and QoL in patients (pts) with cachexia.
METHODS:
Pts with cancer-related cachexia were enrolled in a 3-months structured program, twice weekly, combining aerobic (10-25 min/session) and resistance training (five exercises, 2-3 sets of 8-12 rep) at moderate to vigorous intensity. Primary outcomes were feasibility (i.e. adherence, attendance) and safety, were monitored throughout the intervention. Secondary outcomes, assessed at baseline and post intervention included: i) body composition evaluated with bioelectrical impedance; ii) anthropometric measures, including body weight (BW), body mass index (BMI) and waist-hip ratio (WHR) iii) functional capacity using 6-minute walking test (6MWT); iv) upper limb strength assessed with handgrip strength test (HGST); v) upper and lower flexibility using back scratch test (BST) and sit and reach test (SRT), respectively; vi) QoL evaluated with EORTC QLQ-C30; vii) physical activity levels assessed with Godin Leisure-Time Exercise. Descriptive analysis and absolute frequencies were used for data analysis.
RESULTS:
Five women (mean age 51.2 years; mean BMI 19.1kg/m²), with pancreatic (n=3), breast (n=1) and stomach cancer (n=1), affected by cancer-related cachexia and an unintentional weight loss ranging from 7% to 24% of usual body weight, participated in the study. Four pts had received previous anticancer treatment (chemotherapy) and four were still undergoing active treatment. Attendance and adherence to the prescribe sessions range from 54% to 96% and no dose modification were required. No serious adverse event was reported. Anthropometric measures (BW, BMI and WHR) remained stable for all pts; fat mass was decrease in four pts (-18.1%; -50.7%) while fat-free mass was maintained or increased in three pts (0.9%; 6.8%). Increases in 6MWT (5.5%; 12.5%) HGST (1.1%; 16.5%), and SRT (+13; +26 cm) were observed in four pts, whereas 2 pts enhanced BST ( -4; +5 cm). Four pts, improved functioning domains of QoL but also some symptoms, especially fatigue.
CONCLUSION:
A 3-months structured exercise was feasible and safe in patients with cancer-related cachexia. Exercise can maintain or improve muscle mass, functional capacity, strength, and QoL, supporting its role as a supportive strategy in cachexia management.