Zie ook literatuurlijst van voeding, voedingsuppletie en weinig belastende behandelingen specifiek bij eierstokkanker van arts-bioloog drs. Engelbert Valstar

7 augustus 2023:

zie ook dit artikel: https://kanker-actueel.nl/bewegen-en-sporten-voorkomt-en-herstelt-ernstige-vermoeidheid-bij-kankerpatienten-blijkt-uit-grote-studies-iedere-kankerpatient-zou-een-bewegingsprogramma-moeten-worden-voorgeschreven-aldus-de-onderzoekers.html

7 augustus 2023: Bron: JAMA, 1 augustus 2023

Een zes maanden durend aerobics bewegingsprogramma naast chemotherapie verbetert statistisch significant de zelfgerapporteerde door chemotherapie geïnduceerde perifere neuropathie (CIPN) bij patiënten die worden behandeld voor eierstokkanker met chemotherapie. De gerandomiseerde studie Activity and Lifestyle Study in Connecticut (WALC) vergeleek een aerobicsprogramma met een aandachtcontrole aanpak bij totaal 134 patiënten waarvan 69 patiënten in de aerobicsgroep en 65 patiënten in de aandachtcontrolegroep. Tekst gaat verder onder grafiek.

Secondary analysis of the effect of exercise on chemotherapy-induced peripheral neuropathy (CIPN) among patients treated for ovarian cancer

Anlan Cao, M.B.B.S. en collega's, van de Yale University in New Haven, Connecticut ontdekten dat na zes maanden de zelfgerapporteerde perifere neuropathie (CIPN) -score 1,3 punten lager was in de bewegingsinterventiegroep (95 procent betrouwbaarheidsinterval, -2,3 tot -0,2) versus een toename van 0,4 punten in de aandachtscontrolegroep (95 procent betrouwbaarheidsinterval). interval, −0,8 tot 1,5). Het verschil tussen de groepen was −1,6 punten (95 procent betrouwbaarheidsinterval, −3,1 tot −0,2).
Onder deelnemers met al CIPN-symptomen bij aanvang van de studie was de puntschatting nog groter (−2,0; 95 procent betrouwbaarheidsinterval, −3,6 tot −0,5).

Conclusie van de onderzoekers:

Bevindingen van deze secundaire analyse suggereren dat lichaamsbeweging een veelbelovende behandeling is voor perifere neuropathie (CIPN) en het opnemen van verwijzingen naar oefenprogramma's in de standaard oncologische zorg kan CIPN-symptomen verminderen en de kwaliteit van leven verhogen voor overlevenden van eierstokkanker.

Het volledige studierapport is gratis in te zien of te downloaden. Klik op de titel van het abstract:

visual abstract icon 
Secondary analysis of the effect of exercise on chemotherapy-induced peripheral neuropathy (CIPN) among patients treated for ovarian cancer
Key Points

Question  What is the effect of exercise on chemotherapy-induced peripheral neuropathy (CIPN)?

Findings  In this secondary analysis of a randomized clinical trial of 134 patients with ovarian cancer, the self-reported CIPN score was 1.6 points lower in those who were randomized to the exercise intervention compared with the attention control group, indicating significant improvement in CIPN symptoms.

Meaning  Findings of this secondary analysis suggest that exercise is a promising treatment for CIPN and incorporating exercise program referrals into the standard oncology care may reduce CIPN symptoms and increase quality of life for survivors of ovarian cancer.


Importance  Chemotherapy-induced peripheral neuropathy (CIPN), one of the most common and severe adverse effects of chemotherapy, is associated with worse quality of life among survivors of ovarian cancer. Currently, there is no effective treatment for CIPN.

Objective  To evaluate the effect of a 6-month aerobic exercise intervention vs attention-control on CIPN among women treated for ovarian cancer in the Women’s Activity and Lifestyle Study in Connecticut (WALC) to provide evidence to inform the guidelines and recommendations for prevention or treatment of CIPN.

Design, Setting, and Participants  This prespecified secondary analysis evaluated the Women’s Activity and Lifestyle Study in Connecticut (WALC), a multicentered, open-label, population-based, phase 3 randomized clinical trial of an aerobic exercise intervention vs attention control for CIPN in patients who were diagnosed with ovarian cancer. Only WALC participants who received chemotherapy were included in this analysis. Participants were randomized 1:1 to either a 6-month aerobic exercise intervention or to attention control. All analyses were conducted between September 2022 and January 2023.

Interventions  The exercise intervention consisted of home-based moderate-intensity aerobic exercise facilitated by weekly telephone counseling from an American College of Sports Medicine/American Cancer Society–certified cancer exercise trainer. Attention control involved weekly health education telephone calls from a WALC staff member.

Main Outcomes and Measure  Change in CIPN was the primary outcome in this secondary analysis. This outcome was represented by CIPN severity, which was self-measured by participants at baseline and 6 months using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity scale, with a score range of 0 to 44. A mixed-effects model was used to assess the 6-month change in CIPN between the exercise intervention and attention control arms.

Results  Of the 134 participants (all females; mean age, 57.5 [8.3] years) included in the analysis, 69 were in the exercise intervention arm and 65 were in the attention control arm. The mean (SD) time since diagnosis was 1.7 (1.0) years. The mean (SD) baseline CIPN scores were 8.1 (5.6) in the exercise intervention arm and 8.8 (7.9) in the attention control arm (P = .56). At 6 months, the self-reported CIPN score was reduced by 1.3 (95% CI, −2.3 to −0.2) points in the exercise intervention arm compared with an increase of 0.4 (95% CI, −0.8 to 1.5) points in the attention control arm. The between-group difference was −1.6 (95% CI, −3.1 to −0.2) points. The point estimate was larger among the 127 patients with CIPN symptoms at enrollment (−2.0; 95% CI, −3.6 to −0.5 points).

Conclusions and Relevance  Findings of this secondary analysis of the WALC trial indicate that a 6-month aerobic exercise intervention vs attention control significantly improved self-reported CIPN among patients who were treated for ovarian cancer. While replication of the findings in other studies is warranted, incorporating referrals to exercise programs into standard oncology care could reduce CIPN symptoms and increase quality of life in patients with ovarian cancer.

Trial Registration  ClinicalTrials.gov Identifier: NCT02107066

Article Information

Accepted for Publication: June 20, 2023.

Published: August 1, 2023. doi:10.1001/jamanetworkopen.2023.26463

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2023 Cao A et al. JAMA Network Open.

Corresponding Author: Anlan Cao, MBBS, Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St, New Haven, CT 06520-803 (anlan.cao@yale.edu).

Author Contributions: Drs Irwin and Ferrucci had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Ligibel, Schwartz, Esserman, Irwin, Ferrucci.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Cao.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Cao, Li, Esserman.

Obtained funding: Irwin.

Administrative, technical, or material support: Cartmel, Harrigan, Gogoi, Schwartz, Ferrucci.

Supervision: Gogoi, Esserman, Irwin, Ferrucci.

Conflict of Interest Disclosures: Dr Cartmel reported receiving grants from National Cancer Institute during the conduct of the study. Dr Esserman reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Ferrucci reported receiving grants from National Cancer Institute during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was supported by grants NCI 5R01CA138556 and P30 CA016359 from the National Cancer Institute at the NIH, grant UL1TR000142 from the National Center for Advancing Translational Science at the NIH, and grant P30AG021342 from the Yale Claude D. Pepper Older Americans Independence Center.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 3.

Additional Contributions: Certain data were collected from the Connecticut Tumor Registry located in the Connecticut Department of Public Health. We thank all of the study participants and physicians; Rajni Mehta, MPH, Director of the Rapid Case Ascertainment Shared Resource, Yale Cancer Center; and the following Connecticut hospitals: Charlotte Hungerford Hospital, Bridgeport Hospital, Danbury Hospital, Hartford Hospital, Middlesex Hospital, New Britain General Hospital, Bradley Memorial Hospital, Yale/New Haven Hospital, St Francis Hospital and Medical Center, St Mary’s Hospital, Hospital of St Raphael, St Vincent’s Medical Center, Stamford Hospital, William W. Backus Hospital, Windham Hospital, Eastern Connecticut Health Network, Griffin Hospital, Bristol Hospital, Johnson Memorial Hospital, Day Kimball Hospital, Greenwich Hospital, Lawrence and Memorial Hospital, Milford Hospital, New Milford Hospital, Norwalk Hospital, Sharon Hospital, and Waterbury Hospital. None of these groups and individuals were financially compensated for their contributions.

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