Fatigue is a common adverse effect suffered by prostate cancer patients receiving androgen deprivation therapy (ADT). A growing body of evidence has proposed exercise as a treatment to relieve and prevent the adverse effects of ADT. Recently, high-quality randomized controlled trials (RCTs) of supervised exercise have been conducted to get more assessment. However, the pooled estimate for the effect of supervised exercise on fatigue has not been established yet. This study aims to determine the pooled effect of supervised exercise on fatigue in prostate cancer patients receiving ADT.
A literature search was conducted from PubMed, Clinicaltrial, and Cochrane Library, published up to January 2020 following the PRISMA guideline. We screened RCTs with our inclusion criteria and assessed the quality using the tools provided by Cochrane. The primary outcome analyzed in this study was fatigue measured as Standardized Mean Difference (SMD) with 95% Confidence Intervals (CIs). Heterogeneity was assessed using the I2 test. Subgroup analysis was conducted to determine the difference in exercise duration (<12 weeks and >12 weeks), modality (aerobic, resistance, and combination), and the onset of ADT (initiation and long-term). All analysis was performed using STATA 16.
A total of 7 RCTs comprising 455 patients reported the fatigue using the FACIT-Fatigue, EORTC QLQ-C30, and Schwartz Cancer Fatigue Scale. The included studies presented a low risk of bias. Supervised exercise showed an overall reduction on fatigue (SMD = 0.25, 95%CI 0.07-0.44, p = 0.01, I2 = 0%). The subgroup test results showed no significant difference between exercise duration (p = 0.4), modality (p = 0.67), and onset of ADT (p = 0.57). The Egger’s test results showed no indication of publication bias (p = 0.64).
Supervised exercise reduces fatigue in prostate cancer patients receiving ADT. The available data show that there is no difference between exercise duration and modality. Furthermore, our findings highlight the benefits of supervised exercise in the initiation of ADT for preventing toxicities as well as relieving adverse effects in long-term ADT.
The authors.
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All authors have declared no conflicts of interest.