Deterioration in Physical Fitness and Changes in Body Composition After Cisplatin-Based Chemotherapy for Metastatic...

Cisplatin-based chemotherapy (CBCT) is standard treatment for most men with metastatic testicular cancer (TC). The main objective was to evaluate changes in physical fitness and body composition from before to immediately after CBCT and 3 months after completion of CBCT.

The assessments included cardiorespiratory fitness (peak oxygen uptake [VO₂ peak]), muscle strength (1 repetition maximum [1RM]) and muscular endurance in leg- and chest press, body composition (dual-energy X-ray absorptiometry), physical activity (PA) levels, and patient-reported outcomes (functional scales, global quality of life [QoL], mental health and fatigue). Twenty-eight patients were included, most with low-volume metastatic disease and all within the good prognosis risk group.

From before the start of CBCT to immediately after the last CBCT cycle, there were significant reductions in VO₂ peak by 24% (P < .001), 1RM leg press by 8% (P = .004), 1RM chest press by 17% (P = .001), chest press endurance by 22% (P = .005), total lean body mass by 2.2 kg (P < .001), PA level, physical-, role-, cognitive- and social functioning, and QoL; and significant increases in total and physical fatigue and symptoms of depression. There was a good correlation between reductions in VO₂ peak and QoL during CBCT (r = 0.54, P = .016), whereas no correlation between reductions in VO₂ peak and PA levels. Twelve weeks after CBCT, all variables had returned to baseline values except for PA levels and physical functioning.

TC patients should be prepared for reductions in physical fitness and QoL during CBCT. The reduction in cardiovascular fitness is possibly independent of the PA level.