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Quality of life of prostate cancer survivors participating in a remotely delivered web-based behavioral intervention pilot randomized trial
Langlais CS, Chen YH, Van Blarigan EL, Kenfield SA, Kessler ER, Daniel K, Ramsdill JW, Beer TM, Graff RE, Paich K, Chan JM, Winters-Stone KM
Integrative Cancer Therapies 2022 Jan-Dec;21:15347354211063500
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Following a prostate cancer (PC) diagnosis, treatment-related symptoms may result in diminished quality of life (QoL). Improved diet and increased exercise may improve QoL in men with PC. METHODS: We conducted a 4-arm pilot randomized trial to assess feasibility and acceptability of a 3-month web-based diet and exercise intervention, among men (> 18 years of age) with PC (reported elsewhere). The purpose of this study is to describe the change in QoL measured by surveys (eg, QLQ-C30, PROMIS Fatigue) at enrollment and following the intervention. Men were randomized 1:1:1:1 to increasing levels of web-based behavioral support: Level 1: website; Level 2: Level 1 plus personalized diet and exercise prescription; Level 3: Levels 1 to 2 plus Fitbit and text messages; Level 4: Levels 1 to 3 plus 2 30-minute coaching calls. T-tests were used to compare pre-post change in mean QoL scores between each Level and Level 1. RESULTS: Two hundred and two men consented and were randomized (n = 49, 51, 50, 52 for Levels 1 to 4, respectively). Men were predominantly white (93%), with a median age of 70 years (Intra-quartile Range (IQR) 65 to 75) and 3 years (IQR 1 to 9) post primary treatment for mostly localized disease (74% with T1 to 2). There were no meaningful changes in QoL, but there were notable trends. Level 3 participants had small improvements in QLQ-C30 Global Health (5.46; 95% CI -0.02 to 10.95) compared to Level 1. In contrast, Level 2 participants trended toward decreasing Global QoL (-2.31, 95% CI -8.05 to 3.42), which may reflect declines in function (eg, Cognitive: -6.94, 95% CI -13.76 to -0.13) and higher symptom burden (eg, Diarrhea: 4.63, 95% CI -1.48 to 10.74). CONCLUSIONS: This short, web-based intervention did not appear to have an impact on PC survivors' QoL. Most men were several years past treatment for localized disease; the potential for this approach to reduce symptoms and improve QoL in men who have worse health may still be warranted.

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