Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study

Benedikte Western, Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
Andreas Ivarsson, Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden.
Ingvild Vistad, Department of Clinical Science, University of Bergen, Bergen, Norway.
Ingrid Demmelmaier, Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
Neil K. Aaronson, Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Gillian Radcliffe, Lane Fox Respiratory Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Marc van Beurden, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Martin Bohus, Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
Kerry S. Courneya, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
Amanda J. Daley, Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Daniel A. Galvão, Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.
Rachel Garrod, Department of Respiratory Medicine, King's College London, London, UK.
Martine M. Goedendorp, Department of Psychology, University of Groningen, Groningen, Netherlands.
Kathleen A. Griffith, The George Washington University, Washington, District of Columbia, USA.
Wim H. van Harten, Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Sandi C. Hayes, School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Fernando Herrero-Roman, Fundación GIAFyS Cancer, Miranda de Ebro, Spain.
Anouk E. Hiensch, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Melinda L. Irwin, Yale School of Public Health, New Haven, Connecticut, USA.
Erica James, School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
Marlou-Floor Kenkhuis, Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Marie José Kersten, Department of Hematology, Amsterdam University Medical Centers, Cancer Center Amsterdam and LYMMCARE, Amsterdam, The Netherlands.
Hans Knoop, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Alejandro Lucia, European University, Madrid, Spain.
Anne M. May, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Alex McConnachie, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Willem van Mechelen, Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Nanette Mutrie, Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UK.
Robert U. Newton, Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.
Frans Nollet, Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Hester S. Oldenburg, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Ron Plotnikoff, Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, New South Wales, Australia.

Document Type

Journal Article

Publication Date

2-1-2024

Journal

Scandinavian journal of medicine & science in sports

Volume

34

Issue

2

DOI

10.1111/sms.14575

Keywords

cancer; decision tree; exercise oncology; individual patient data meta-analysis

Abstract

INTRODUCTION: The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. METHODS: This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. RESULTS: Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m exercising during (5.2%) or post (9.5%) treatment. CONCLUSIONS: There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.

Department

Nursing Faculty Publications

Link to Full Text

Share

COinS