Patient‐reported outcomes, body composition, and nutrition status in patients with head and neck cancer: Results from an exploratory randomized controlled exercise trial

BACKGROUND Patients with head and neck cancer experience loss of weight and muscle mass, decreased functioning, malnutrition, depression, and declines in quality of life during and after treatment. The purpose of this exploratory randomized study was to determine the optimal timing for the initiation of a lifestyle and progressive resistance exercise training intervention (during or after radiation therapy), as determined by intervention adherence and by comparing between‐group outcomes across 24 weeks. METHODS Sixty patients with head and neck cancer were randomized to engage in a 12‐week lifestyle intervention and progressive resistance‐training program either during radiation treatment or immediately after completion. The primary outcome of body composition—specifically, lean body mass, body mass index, and body fat—as well as secondary outcomes of fitness, quality of life, depression, and nutrition status were evaluated. RESULTS The progressive resistance‐training intervention carried out during treatment did not significantly influence the primary outcome of body composition, despite a significant increase in weekly physical activity reported by the intervention group. A small‐to‐medium intervention effect was noted for some secondary outcomes, including fitness, quality of life, and nutrition status. Regardless of whether patients received the immediate or delayed progressive resistance‐training intervention, the analysis revealed a main effect of time on body composition, fitness, quality of life, depression, and nutritional scores. CONCLUSIONS Although the intervention during treatment did not reduce the loss of lean body mass, delaying the exercise program until after treatment completion was associated with improved intervention adherence, a finding with important clinical implications. Cancer 2016;122:1185–200. © 2016 American Cancer Society. A physical activity lifestyle intervention for head and neck cancer patients during radiation treatment does not mitigate losses in body composition but may alleviate losses in fitness, QOL, and nutrition status. Intervention adherence supports improved patient participation and ease of participation post‐radiation rather than during radiation therapy.