325P - Physical rehabilitation in breast cancer patients which tests to adapt training program?

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer, Early Stage
Supportive Care
Presenter Caroline Laval
Citation Annals of Oncology (2014) 25 (suppl_4): iv85-iv109. 10.1093/annonc/mdu327
Authors C. Laval1, F. Vincent2, M. Antonini2, S. Leobon3, L. Venat-Bouvet4, N. Tubiana-Mathieu4
  • 1Physiology, University Hospital, 87000 - Limoges/FR
  • 2Physiology, University Hospital, Limoges/FR
  • 3Medical Oncology, University Hospital, 87000 - Limoges/FR
  • 4Medical Oncology, University Hospital, Limoges/FR

Abstract

Aim

Numerous studies report that adapted exercise training is a recommended component of rehabilitation in patients receiving adjuvant treatment for breast cancer. Peak oxygen consumption (VO2peak) obtained from cardiopulmonary exercise testing (CPET) are used for determine the intensity of exercise training program. However, CPET is relatively expensive and time consuming and distance walked during a six-minute walk test (6-MWT) is commonly employed in clinical practice for determine cardiorespiratory fitness (CRF). However, the relationship between VO2peak and 6 MWD has not been clearly defined in cancer rehabilitation program.

Methods

79 subjects (median age 50 years (35-70); stage I to III breast cancer) were evaluated before adjuvant chemotherapy and radiotherapy. They were included in an adapted physical activity program based on cardiopulmonary tests. They performed, under the supervision of an exercise physiologist, a 6MWT and a incremental physician-supervised CPET performed on an electronically-braked cycle ergometer. Age- and sex- predicted 6MWT was calculated from the equation of Enright, maximal oxygen uptake was the highest oxygen uptake during exercise and ventilatory threshold (VT) was determined by a systematic increase in the pulmonary ventilation during exercise.

Results

Patients covered a distance of 526 ± 54 m during 6MWT at an average of 129 ± 16 beats per minute (bpm) of peak heart rate (PHR) and achieved a VO2peak of 22.6 ± 4.5 ml · kg − 1 · min− 1 at an average of 130 ± 14 bpm of PHR at VT. The distance walked was significantly correlated (p < 0.001) but weakly with VO2peak (r = 0.38). Therefore, PHR during 6MWT and PHR (corresponding to the first VT) during VO2peak are significantly and strongly correlated (p < 0.0001and r = 1).

Conclusions

CPET with VO2peak may be the ideal method of measuring aerobic physical condition in cancer patients; however, this method of measurement of VO2max with CPET is not used easily in clinical oncology. PHR collected during the 6MWT seem to be a simple alternative parameter to guide exercise prescription in this cancer population. The implementation of these tests on training programs will describe.

Disclosure

All authors have declared no conflicts of interest.