Effects of a structured intervention program to improve physical activity (PA) of adolescents and young adult cancer survivors (AYAs): Final results of the randomized Motivate AYA–MAYA trial.

Abstract

11518 Background: Major cardiovascular (CV) events are the most common late toxicities among AYAs. Although regular PA of vigorous intensity (≥ 9 metabolic equivalent [MET]-hours/week) lowers the risk for CV events and mortality, no larger randomized controlled trials on interventions are available. Our aim was to assess whether a 12-week structured intervention increases the vigorous PA of AYAs. Methods: AYAs aged 15 to 39 years, after curative intent cancer treatment with at least one CV risk factor, were randomized to usual-care control group (CG) and to intervention group (IG). The CG received standard recommendations, and the IG participated at a semi-structured interview and phone consulting focusing on PA and behavioral change. At baseline, post-intervention (12 wks), and at follow-up (52 wks), participants completed the International Physical Activity Questionnaire (IPAQ) and quality of life assessment (EORTC QLQ-C30). Primary endpoint was the rate of AYAs with ≥ 9 MET-hours/week of vigorous activity (IPAQ) at 12 weeks. This single center trial was registered (DRKS00009453). Results: Among 115 screened AYA 89 eligible patients were randomized; 69 (77.5%) completed the intervention and the endpoint assessment; 36 (52.2%) were in the IG and 33 (47.8%) in the CG. Median age was 24.3 years (range, 18 to 39). CV risk factors were use of anthracyclines (94.2%), chest radiation (47.8%), or both (44.9%). At baseline 49.2% of all AYAs reported to perform vigorous PA with at least 9 MET-hours/week, although reporting was individually biased. Post-intervention this rate significantly increased in the IG from 45.7% to 69.7% (p = 0.007), whereas in the CG only a modest non-significant increase was noted (53.3% to 65.6%, p = 0.134). Notably, upon long-term follow up (52 wks) AYAs did not keep their increased vigorous PA, whereas improved moderate PA was achieved (MET score in IG p = 0,044). Also, both groups reduced significantly the time they spent sitting from 6.5 (SD, 2.9) to 5.4 (SD, 2.7) hours/day (p = 0.001). Conclusions: Intensified PA counseling improves short term vigorous PA and long term moderate PA of AYAs and, should thus be part of survivorship programs. Further studies with AYAs will be required to establish reliable PA screening methods and to confirm the results in larger cohorts. Clinical trial information: DRKS00009453.