Resistance Exercise, Muscle Mass, And Fatigue In Head And Neck Cancer Patients Undergoing Chemoradiation

Chemoradiation therapy (CRT) is the standard of care treatment for Head and Neck Cancer (HNCa) patients. Despite its established therapeutic efficacy, adverse effects accompanying CRT result in clinically-meaningful declines in muscle mass and increases in cancer-related fatigue. The adverse effects observed during CRT place HNCa patients at heightened risk for functional decline, mortality, and morbidity. Accordingly, there is a pressing need to evaluate the utility of supportive care interventions, such as resistance exercise (RE), to attenuate the deleterious effects observed during CRT. PURPOSE: Determine the utility of implementing a group-mediated cognitive behavioral (GMCB) RE intervention in the treatment of HNCa patients undergoing CRT. In the current study, we evaluated the effects of the RE intervention for preserving muscle mass and countering cancer-related fatigue. METHODS: The HNCaRE study was a single-arm, pilot trial in 20 HNCa patients undergoing CRT. Assessment of outcomes were obtained at baseline, 3-months, and 6-month follow-up visits. RESULTS: Results of a completer’s (n = 11) ANCOVA analysis yielded a significant effect for muscle mass (p < 0.01). Findings revealed clinically-meaningful declines in muscle mass from baseline to 3-months (d = -0.85) and 6-months (d = -0.53). Although the results of ANCOVA analysis were non-significant for fatigue (p > 0.34), small to medium effect size declines in fatigue were observed from at 3-months (d = -0.30) and 3 to 6-months (d = -0.49). CONCLUSIONS: Findings from the HNCaRE pilot trial support the feasibility of implementing a GMBC-based RE intervention among HNCa patients undergoing CRT and provide evidence of the preliminary efficacy of this approach for meaningfully attenuating the magnitude of the declines in muscle mass and increases in cancer-related fatigue consistently documented during standard of care CRT. These promising results underscore the potential utility of integrating the GMCB RE intervention in the supportive care of HNCa patients undergoing CRT.