Effects of Exercise on Cognitive Impairment in Patients Receiving Chemotherapy: A Multicenter Phase III Randomized Controlled Trial.

EXCAP participants on 2-week chemotherapy cycles reported significantly less overall cognitive impairment compared with usual care participants.

• Mean difference (SE) for overall cognitive impairment: 7.0 (3.3), P=.04
• The intervention was a 6-week home-based, individually tailored exercise program called Exercise for Cancer Patients (EXCAP)
• Cognitive impairment was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog)
• Between-group differences were examined using Analysis of Covariance (ANCOVA)

EXCAP participants on 2-week chemotherapy cycles reported significantly less perceived cognitive impairment compared with usual care participants.

• Mean difference (SE) for perceived cognitive impairment: 4.1 (2.1), P=.05
• This was a specific subscale finding within the overall cognitive impairment assessment
• Analysis was limited to patients receiving chemotherapy on 2-week cycles

EXCAP participants on 2-week chemotherapy cycles received significantly fewer comments from others identifying cognitive impairment.

• Mean difference (SE) for comments from others identifying cognitive impairment: 0.6 (0.2), P=.02
• This represents an externally observed measure of cognitive impairment, distinct from self-reported perception
• Finding was specific to participants on 2-week chemotherapy cycles

EXCAP participants on 2-week chemotherapy cycles reported significantly less mental fatigue compared with usual care participants.

• Mean difference (SE) for mental fatigue: -1.6 (0.5), P<.01
• Mental fatigue was assessed using the Multidimensional Fatigue Symptom Inventory (MFSI)
• This finding was specific to participants receiving 2-week chemotherapy cycles

All EXCAP participants, regardless of chemotherapy cycle duration, reported significantly less mental fatigue compared with usual care participants.

• Mean difference (SE) for mental fatigue across all participants: -0.7 (0.3), P=.02
• This finding held regardless of chemotherapy cycle duration, suggesting a broader effect of exercise on mental fatigue
• Mental fatigue was assessed using the Multidimensional Fatigue Symptom Inventory

Suppressed inflammatory responses were associated with cancer-related cognitive impairment in patients receiving chemotherapy.

• Structural equation modeling (SEM) was used to examine the relationships between inflammatory responses and CRCI
• Coefficient (SE): 0.2 (0.1), P<.01
• Inflammatory markers assessed included IL-1β, IL-6, IL-8, IL-10, IFN-γ, and sTNFR1
• A healthy inflammatory response, characterized by increases in both proinflammatory and anti-inflammatory cytokines, was associated with less cognitive impairment

The study design was a multicenter phase III randomized controlled trial enrolling patients diagnosed with any cancer type scheduled to start chemotherapy.

• Patients were randomized to either EXCAP or usual care
• The EXCAP intervention was 6 weeks in duration and home-based and individually tailored
• Blood samples were collected to assess inflammation
• Up to 75% of patients experience cancer-related cognitive impairment during treatment, per the background cited in the abstract