Patients with high-grade glioma (HGG) undergo aggressive treatments, experience significant adverse-effects and report high unmet needs. Exercise may be an effective intervention to aid management of HGG but no previous research has examined the potential impact of exercise among these patients. This study aimed to evaluate if exercise is a feasible and safe therapy in patients with HGG undergoing chemoradiotherapy.
29 patients (69% men; 52±12 years) with HGG scheduled to receive chemoradiotherapy participated in this pilot study. Patients self-selected to receive either usual care (n=5) or a supervised exercise intervention (n=24) throughout chemoradiotherapy. The intervention involved an individualised prescription of moderate-intensity aerobic and resistance exercise during twice weekly sessions delivered at the hospital. Assessment of quality of life (QOL), fatigue, distress, physical function and body composition were conducted ≤10 days prior to and following chemoradiotherapy.
Four (14%) participants withdrew from the exercise intervention; baseline characteristics did not differ significantly from non-withdrawers (p≤0.05). Exercise session attendance was ~80±4% and one adverse event relating to the intervention was reported in which a patient aggravated a previous shoulder injury (no medical attention required, patient completed the intervention). The intervention improved function (13% increase in maximal strength, 6% improvement in repeated chair rise; p≤0.05) but few other changes were observed. The changes were influenced by whether participants were receiving dexamethasone. Function significantly improved (19% maximal strength, 7% repeated chair rise, 6% ambulation; p≤0.05) while QOL and symptoms did not worsen in exercising patients not receiving dexamethasone. Patients receiving dexamethasone significantly decreased QOL (22%), increased fat mass (3.5kg/2.9% body fat) and did not improve function despite exercising.
Supervised exercise is safe and well tolerated by HGG patients undergoing chemoradiotherapy. Outcomes following exercise were better in HGG patients not receiving dexamethasone. Randomised controlled trials are required to further explore these findings.