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Can physical exercise prevent cardiotoxicity in breast cancer patients? Rationale of a randomized controlled trial
Session:
Posters 1 - Écran 8 - Enfermagem/Técnicos
Speaker:
Pedro Antunes
Congress:
CPC 2019
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Posters
FP Number:
---
Authors:
Pedro Antunes; Dulce Esteves; António Ascensão ; Francisco Sampaio; Eduardo Vilela; Madalena Teixeira; José Magalhães; Jorge Beleza; Anabela Amarelo; Ana Joaquim
Abstract
<p><strong>BACKGROUND: </strong>Cardiac dysfunction induced from conventional cardiotoxic drugs in breast cancer treatment, such as anthracyclines, has been recognized as a major concern in clinical practice, interfering with optimal cancer management and patients’ quality of life. As such, the implementation of adequate supportive strategies is needed. Physical exercise (PE) has been proposed as a potential approach to mitigate anthracycline-related cardiotoxicity. However, due to the scarcity of available evidence, the full scope of this hypothesis is yet to be fully ascertained. Clinical trials that address this literature gap are of pivotal importance.</p> <p><strong>PURPOSE: T</strong>o analyse the effects of a supervised PE program on cardiotoxicity markers in women who will be treated with anthracycline-based chemotherapy (AB-CT).</p> <p><strong>METHODS:</strong> This is a study protocol for a two-arm prospective randomized controlled trial, registered on International Standard Randomised Controlled Trial Number: ISRCTN32617901. Nineteen adult women with early breast cancer and with a therapeutic decision to receive AB-CT, will be randomly assigned (1:1 ratio) to an intervention group or to a control group. Patients allocated to the intervention group will perform a 3-weekly supervised PE program combining resistance and aerobic training with progressive intensity (light-to-high), during treatment. The control group will receive usual cancer care. Resting left ventricular (LV) global longitudinal strain (GLS) and resting LV ejection fraction (LVEF) will be assessed at three time-points: 1-14 days prior to start of the AB-CT (M1); 1-5 days after the end of the AB-CT (M2) and 3 months after M2 (M3). For resting LV GLS assessment, two-dimensional grey-scale images will be acquired in the apical four-, two- and three-chamber views. Resting LVEF will be calculated using the biplane method of disks (modified Simpson’s rule) from the apical four- and two-chamber view. To analyse N-terminal pro-B-type natriuretic peptide, blood samples will be collected at M1, M2, M3 and 24 hours before each anthracycline cycle. Cardiorespiratory fitness will also be assessed at M1, M2, M3, by a symptom-limited cardiopulmonary exercise test on a treadmill.</p> <p><strong>DISCUSSION: </strong>We expect this study will contribute to better understand the role of PE at counteracting anthracycline-related cardiotoxicity and to further facilitate the integration of policies, which aim to balance the negative cardiac effects from the use of cardiotoxic drugs in cancer care.</p>
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