Abstract P5-14-02: Yoga for chemotherapy-induced peripheral neuropathy and fall risk in breast and gynecological cancer survivors: A pilot study
Authors: Bao Ting , Hooper Madeline , Baser Raymond , Chen Patricia , Piulson Lauren , Patterson Clare , Paul Tina , Chen Connie , Li Qing , Panageas Katherine , Zhi Iris , Blinder Victoria , Robson Mark , Seidman Andrew , Mao Jun 
Published: March 2020

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating and dose-limiting side effect of neurotoxic chemotherapies that worsens quality of life and increases fall risk in cancer survivors. CIPN is painful and poorly managed with pharmacological agents.This pilot study assessed the preliminary effect of yoga on CIPN symptom severity and fall risk in cancer survivors.Methods: Breast and gynecological (GYN) cancer survivors with persistent, moderate-to-severe CIPN were randomized to yoga and usual care (UC) control arms. The yoga arm practiced Hatha yoga for 60 minutes daily via an in-person group class (2 times/week) and at home using a study-provided instructional video (5 times/week), and the UC arm received usual care for 8 weeks. Main study outcomes included a numeric rating scale (NRS) of CIPN pain, numbness and tingling (higher score indicates worse symptom); the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicitysubscale (FACT-GOG/Ntx) (higher score indicates improved symptoms); and functional reach (FR) test, an objective balance test used to evaluate fall risk (higher score indicates lower risk of fall). Mean changes from baseline to week 8 were calculated for each outcome measure and compared between treatment arms using two-sample t-tests. Results: From 2/2018 to 5/2019, 41 female cancer survivors (92.7% breast, 7.3% GYN; mean (SD) age 62.6 (10.2) years; 53.7% white/non-Hispanic, 19.5% African American, 12.2% Asian, 12.2% other) were enrolled and randomized to yoga (N=21) and UC (N=20) arms. At week 8, mean NRS pain decreased by 2.06 points (95% CI [-3.27, -0.86]) in the yoga arm, and 0.65 points [-2.08, 0.78] in the UC arm (p=0.12). No statistically significant change was observed in NRS numbness and tingling for yoga versus UC arms (both p&gt;0.5). FACT-GOG/Ntx improved by 4.56 points [-1.84, 7.29] in the yoga arm, and 1.37 points [-0.51, 3.25] in the UC arm (p=0.05). FR improved by 3.08 inches [-1.43, 4.73] in the yoga arm, and decreased 0.59 inches [-0.51, 3.25] in the UC arm (p=0.003). Four yoga and 3 UC subjects reported a total of 11 adverse events deemed possibly related to the yoga intervention (all grade 1). Conclusion: Among breast and GYN cancer survivors with moderate-to-severe CIPN, yoga showed promising effects for improving neuropathy-related pain and quality of life, and for reducing fall risk. An adequately-powered and appropriately-controlled trial is warranted to confirm the specific and long-term effects of yoga on CIPN symptoms and fall prevention.

Citation Format: Ting Bao, Madeline Hooper, Raymond Baser, Patricia Chen, Lauren Piulson, Clare Patterson, Tina Paul, Connie Chen, Qing Li, Katherine Panageas, Iris Zhi, Victoria Blinder, Mark Robson, Andrew Seidman, Jun Mao. Yoga for chemotherapy-induced peripheral neuropathy and fall risk in breast and gynecological cancer survivors: A pilot study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-14-02.