The clinical relevance of serum vascular endothelial growth factor (VEGF) in correlation to circulating tumor cells and other serum biomarkers in patients with metastatic breast cancer |
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Authors: | " target="_blank">Malgorzata Banys-Paluchowski Isabell Witzel Sabine Riethdorf Klaus Pantel Brigitte Rack Wolfgang Janni Peter A Fasching Bahriye Aktas Sabine Kasimir-Bauer Andreas Hartkopf Erich-Franz Solomayer Tanja Fehm Volkmar Müller |
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Institution: | 1.Department of Physiology and Pharmacology,Karolinska Institutet,Stockholm,Sweden;2.Department of Neurobiology, Care Sciences and Society,Karolinska Institutet,Stockholm,Sweden;3.School of Human Movement and Nutrition Sciences,The University of Queensland,Brisbane,Australia;4.Department of Cell and Molecular Biology,Karolinska Institutet,Stockholm,Sweden;5.Department of Oncology and Pathology Cancer Center Karolinska,Karolinska Institutet,Stockholm,Sweden;6.Cancer Theme,Karolinska University Hospital,Stockholm,Sweden;7.Department of Learning, Informatics, Management and Ethics,Karolinska Institutet,Stockholm,Sweden;8.Division of Nursing,Karolinska University Hospital,Stockholm,Sweden |
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Abstract: | BackgroundAdvanced therapeutic strategies are often accompanied by significant adverse effects, which warrant equally progressive countermeasures. Physical exercise has proven an effective intervention to improve physical function and reduce fatigue in patients undergoing chemotherapy. Effects of high-intensity interval training (HIIT) in this population are not well established although HIIT has proven effective in other clinical populations. The aim of the OptiTrain trial was to examine the effects of concurrent resistance and high-intensity interval training (RT-HIIT) or concurrent moderate-intensity aerobic and high-intensity interval training (AT-HIIT), to usual care (UC) on pain sensitivity and physiological outcomes in patients with breast cancer during chemotherapy.MethodsTwo hundred and forty women were randomized to 16 weeks of RT-HIIT, AT-HIIT, or UC. Outcomes: cardiorespiratory fitness, muscle strength, body mass, hemoglobin levels, and pressure-pain threshold.ResultsPre- to post-intervention, RT-HIIT (ES = 0.41) and AT-HIIT (ES = 0.42) prevented the reduced cardiorespiratory fitness found with UC. Handgrip strength (surgery side: RT-HIIT vs. UC: ES = 0.41, RT-HIIT vs. AT-HIIT: ES = 0.28; non-surgery side: RT-HIIT vs. UC: ES = 0.35, RT-HIIT vs. AT-HIIT: ES = 0.22) and lower-limb muscle strength (RT-HIIT vs. UC: ES = 0.66, RT-HIIT vs. AT-HIIT: ES = 0.23) were significantly improved in the RT-HIIT. Increases in body mass were smaller in RT-HIIT (ES = ? 0.16) and AT-HIIT (ES = ? 0.16) versus UC. RT-HIIT reported higher pressure-pain thresholds than UC (trapezius: ES = 0.46, gluteus: ES = 0.53) and AT-HIIT (trapezius: ES = 0.30).ConclusionSixteen weeks of RT-HIIT significantly improved muscle strength and reduced pain sensitivity. Both exercise programs were well tolerated and were equally efficient in preventing increases in body mass and in preventing declines in cardiorespiratory fitness. These results highlight the importance of implementing a combination of resistance and high-intensity interval training during chemotherapy for women with breast cancer. |
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