A randomized controlled trial of a structured exercise intervention after the completion of acute cancer treatment in adolescents and young adults.

Background: Cancer treatments are frequently associated with impaired physical fitness, quality of life (QOL), and fatigue, often persisting into survivorship.  Studies in older adults with cancer have demonstrated benefits from exercise; however, this has not been rigorously investigated in adolescents and young adults (AYA). The aim of this study was to determine whether a structured 10-week exercise intervention was associated with improved cardiorespiratory fitness (VO _2peak ), fatigue, and QOL in AYA who have recently completed cancer treatment.
Method: Forty-three AYA (median age 21 ± 6 years) were randomly assigned to an exercise group (n = 22) or a control group (n = 21). The exercise group received a structured 10-week exercise program comprising progressive aerobic and resistance exercise; the control arm received routine care. VO _2peak was measured at baseline, 10 weeks, and six months. Fatigue and QOL were assessed by the FACIT fatigue scale and the PEDS QL, respectively.
Results: Mean VO _2peak at baseline was 26.5 ± 7.2 mL.kg ^-1 .min ^-1 , which is substantially lower than population norms. The exercise group demonstrated significant improvement in VO _2peak at 10 weeks compared with controls (33.8 ± 8.1 vs 29.6 ± 7.6 mL.kg ^-1 .min ^-1 , P = 0.0002), but by six months, the difference was no longer significant (32.9 ± 7.0 vs 30.9 ± 11.0 mL.kg ^-1 .min ^-1 , P = 0.21). There were no significant differences in fatigue or total QOL scores between groups.
Conclusion: Cancer treatment is associated with reduced VO _2peak in AYA. Improvement in VO _2peak was accelerated by a 10-week exercise program; however, no significant benefit was observed in QOL or fatigue. The plateau in VO _2peak at six months suggests that a maintenance exercise program may be beneficial.
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