While radiation therapy (RT) is effective for reducing cancer burden in breast cancer (BC) patients, its side effects promote sedentary behavior and accumulation of adipose mass. Obesity and inactivity further increase the risk for cardiovascular co-morbidities and mortality. To combat these effects, we piloted a 12-week Stay on Track (SOT) exercise and diet intervention for breast cancer patients during their RT. We hypothesize that SOT will positively influence body composition and metabolic and inflammatory biomarkers in BC patients. A prospective, randomized control trial for patients with non-metastatic BC undergoing whole-breast RT was conducted. The intervention ( A; 21 patients) group participated in 3 personal excercise training sessions, 3 dietary counseling sessions, and received 3 text message reminders per week to adhere to lifestyle recommendations. The control (B; 22 patients ) group received an informative binder. All patients received a Fitbit, and at baseline, 3months, and 6months, measurements of blood biomarkers and dual-energy x-ray absorptiometry (DXA) scans were conducted. A mixed models analysis with a significance value of 0.05 was conducted, and estimated change from baseline with SE’s are reported. There was trend towards lower BMI (-0.95, 0.49; p=0.06) at 6mo and decreased visceral fat (-2.17, 1.22; p=0.081) at 3mo in A only. B had an increase in HbA1C at 3mo compared to baseline (0.26, 0.10; p=0.01) which stayed elevated at 6mo (0.22, 0.13; p=0.08). B also had an increase in glucose levels at 6mo (8.42, 3.94; p=0.04), with a trend towards a decrease in insulin (-14.30, 9.85; p=0.15). A had no changes in these levels. There was a significant decrease in leptin levels at 6mo in B only (-13583.7, 6184.2, p=0.03). Adiponectin levels trended higher in A compared to B at 6mo (3143.42, 2265.1; p=0.17). Analysis of inflammatory cytokines showed a decrease in anti-inflammatory IL-1R-a in B (-3.46, 1.24; p=0.01), and a reduction in pro-inflammatory IL-8 levels in A (-2.77, 1.15; p=0.02). We conclude that SOT may positively influence body composition and metabolic and inflammatory biomarkers in BC patients. Targeted lifestyle interventions during RT are feasible and could help decrease cardiovascular co-morbidities in BC.
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