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A B S T R A C T S

S29

Introduction:

Androgen deprivation therapy (ADT) is

commonly used to treat prostate cancer (PC). However, ADT is

associated with significant side effects including declines in

quality of life (QOL), physical function, and muscle strength.

Existing evidence from multiple clinical trials demonstrates

that exercise in this population is associated with

improvements in many of these side effects. However, these

benefits are most consistently observed with a supervised

1:1 in-centre exercise program which is not economically

sustainable in a public health care setting. Alternative

approaches such as supervised group and home-based

programs are promising but need to be tested rigorously

against 1:1 supervised exercise.

Objectives:

Our primary objective in this phase II trial

was to determine whether group-supervised or home-based

supported programs are non-inferior to a supervised 1:1

exercise program in terms of benefits in QOL and physical

fitness in men with PC on ADT. Secondary objectives include

examination of long-term adherence and cost-effectiveness.

Feasibility endpoints included recruitment, retention, and

adherence rate, satisfaction, and outcome capture.

Methods:

Men diagnosed with histologically confirmed

PC, starting or continuing on ADT for at least 6 months or

who remained biochemically castrate after stopping ADT

were randomized (1 personal training:1 group-supervised:1

home-based). Randomization was stratified by length of ADT

use (<3 months versus

3 months). QOL, fatigue, and fitness

measures were completed every 3 months for 12 months (6

month intervention phase and 6 month follow-up phase).

Participants completed 4-5 days per week of moderate-

intensity, mixed modality exercise incorporating aerobic,

resistance, and flexibility training. Primary outcomes were

analyzed using linear mixed effects model with subject-

specific random effects and group-by-time interactions.

Results:

59 participants (mean age 69.9 years) were

enrolled. The recruitment rate was 28.7% and the retention

rate was 71.2%. The only significant between-group difference

was observed comparing the home-based approach to

the 1:1 arm, with slightly worse Functional Assessment of

Cancer Therapy (FACT) Prostate scores in the home-based

arm (delta 4.79 points, p=0.0103). All other measures of QOL

including the FACT-General and FACT-Fatigue questionnaires

were similar between groups. Grip strength was also slightly

worse in the home-based arm compared to the 1:1 arm (delta

-3.90 kg, p=0.0044). Other fitness measures, including VO2

max, grip strength, and chair stands, were similar between

groups. There were no grade 3 or higher adverse effects. Other

feasibility endpoints were acceptable.

Conclusion:

A group-supervised exercise program in men

with PC on ADT appeared to be non-inferior when compared

to the gold standard 1:1 supervised exercise program for both

QOL and fitness outcomes. A home-based approach also

appeared to be non-inferior for most outcomes. These results

suggest that a less resource-intensive exercise program may

provide similar QOL and fitness benefits and that further

investigation of the efficacy and cost-effectiveness of less

resource-intensive programs in a phase 3 RCT is warranted.

Results and lessons learned from this trial will help to inform

a phase 3 trial.

Disclosure of interest:

None declared

Keywords:

Androgen deprivation therapy, exercise/physical

fitness, fatigue, prostate cancer, quality of life

O11

PREVALENCE AND FACTORS ASSOCIATED WITH HIGH

LEVEL OF DISTRESS AMONG OLDER CANCER PATIENTS

UNDERGOING SURGERY

A. Shahrokni

1,

*, L. Elmquist

2

, B. Korc-Grodzicki

3

and MSKCC

Cancer & Aging Research Program

1

Medicine/Geriatrics and Oncology,

2

Social Work,

3

Medicine/

Geriatrics, Memorial Sloan Kettering Cancer Center, NYC, United

States

Introduction:

Older cancer patients are at increased risk of

suffering high levels of distress (HLD).

Objectives:

Our study aims to assess the prevalence

of HLD among these patients and its association with

sociodemographic and geriatric assessment (GA) factors.

Methods:

Older cancer patients were screened for HLD

using the Distress Thermometer (DT) as a part of geriatric

preoperative evaluation in 2015 DT score ranges from 0 to

10, and those with score

4 were considered to have HLD.

Sociodemographic (age, gender, marital status, education,

and living condition) and GA variables: activities of daily

living (ADL), instrumental Activities of Daily Living (ADL),

patient-rated Karnofsky Performance Scale (KPS) score,

history of falls in the past year, timed up and go (TUG)

test, social support (Medial Outcome Study-Social Support

Survey), social activity limitation (Medical Outcome Study),

weight loss in the past year, depression (geriatric depression

scale(GDS)-4item), and vision and hearing quality were

captured. Bivariate analysis for the association between each

factor and HLD was performed. Variables with statistically

significant (p<0.05) correlation with HLD were entered into a

multivariate analysis model.

Results:

In total 584 patients completed DT (median age

80) and 53.1% had HLD. In bivariate analysis, being female

(p<0.001), marital status other than married (p=0.02), and

living alone (p=0.006) were associated with HLD. Among GA

variables, lower KPS (p<0.001), lower score in ADL (p<0.001),

and iADL (p<0.001), more limitation in social activities

(p<0.001), higher depression score (p<0.001), poor vision

(p<0.001), andTUG

10 seconds (p<0.001) were associated with

HLD. Multivariate analysis showed that being female (OR-

2.66, p<0.001), living alone (OR=2.17, p<0.013), more limited

in social activities (OR=1.23, p<0.001), and higher depression

score (OR=1.44, p<0.001) were associated with HLD.

Conclusion:

More than half of older cancer patients

undergoing surgery experience HLD. Addressing modifiable

factors associated with HLD by involving the appropriate

health professional and treating depression may improve

patients’ distress level.

Disclosure of interest:

None declared

Keywords:

Distress and psycho-social issues, Geriatric

assessment, Preoperative assessment, Surgery