Discussion
ovarian cancer, cancer, CIPN, neurotoxic
ADVERSE EVENTS, OVARIAN CANCER, CANCER
We found that a 6-month aerobic exercise intervention significantly improved self-reported CIPN compared with attention control among patients who had completed chemotherapy for ovarian cancer. We observed a significant between-group difference in self-reported CIPN score of −1.6 points, with the score improving by 1.3 points, a reduction of 16%, in the exercise intervention arm; meanwhile, there was a nonsignificant 0.4-point increase among attention control participants. As reported previously, most participants who were randomized to the exercise intervention in the WALC trial were able to meet the exercise goals, with no reported adverse events.While data were limited on CIPN specific to survivors of ovarian cancer using the FACT/GOG-Ntx scale, Stevinson et alFour RCTs assessed the effects of exercise on CIPN symptoms in posttreatment survivors of cancer,None of the previous trialsThe significant attenuation in CIPN symptoms in the exercise intervention arm could be attributed to both objective improvements in neural functions and subjective improvements in participant perception of these CIPN components. Streckmann et alWhen patients report CIPN symptoms, chemotherapy dose and schedules may be altered to reduce neurotoxic effects. Since chemotherapy dose reductions and dose delays are associated with higher ovarian cancer mortality,When restricted to participants who had CIPN symptoms at enrollment, we observed a larger effect size with exercise (−2.0; 95% CI, −3.6 to −0.5). Since 94.8% of participants had at least 1 CIPN symptom at baseline, we could not evaluate an interaction by CIPN symptoms at baseline or determine whether the exercise intervention could prevent CIPN among participants without CIPN at enrollment.