The effect of progressive resistance training on lean soft tissue mass in head and neck cancer patients during concomitant chemoradiotherapy: the DAHANCA 31 randomized controlled trial

Authors

  • Camilla K. Lonkvist Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark https://orcid.org/0009-0003-9692-0839
  • Simon Lønbro Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Public Health, Section for Sport Science, Aarhus University, Aarhus, Denmark https://orcid.org/0000-0002-7258-3191
  • Anders Vinther Department of Physiotherapy and Occupational Therapy and Hospital, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0003-1993-3102
  • Bo Zerahn Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark https://orcid.org/0000-0002-3457-6249
  • Eva Rosenbom Nutritional Research Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
  • Mads Vansted Svart Department of internal medicine, Regional Hospital Horsens, Horsens, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. https://orcid.org/0000-0002-9574-0612
  • Morten Lyng Høgild Medical Research Laboratory, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark https://orcid.org/0000-0002-2442-6992
  • Hanne Primdahl Department of Oncology, Aarhus University Hospital, Aarhus, Denmark https://orcid.org/0000-0003-3562-0026
  • Julie Gehl Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0003-3829-0210

DOI:

https://doi.org/10.2340/1651-226X.2026.45545

Keywords:

Resistance training, Head-and-neck cancer, Chemoradiotherapy, body composition, Muscle Strength, functional performance

Abstract

Background and purpose: Head and neck cancer patients undergoing concurrent chemoradiation treatment (CCRT) lose a significant amount of lean soft tissue mass (LSTM) reducing muscle strength and performance. Progressive resistance training (PRT) may mitigate this loss and improve muscle strength and performance. The purpose was to investigate the effects of PRT initiated at CCRT onset on LSTM, muscle strength, and functional performance compared with usual care.

Patients/material and methods: Patients were randomized to 12 weeks of PRT (36 sessions) or usual care with no exercise (control group [CON]). At baseline, after 6 and 12 weeks, 6 and 12 months, Dual-Energy Absorptiometry evaluated total body mass (BM), LSTM, and fat mass (FM); 1 repetition maximum (1RM) chest press and leg press test assessed maximal muscle strength and functional performance (30 seconds chair-rise; 30 seconds arm curls; stair climb) was evaluated. Dietary intake was registered as were Quality of Life questionnaires European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) C30 and QLQ H&N-35. A sample size of 72 patients (36 per group) was determined a priori with LSTM as the primary endpoint.

Results: Fifty patients were included (required sample size was not met), 25 in each group. From baseline to 12 weeks, patients in the PRT group lost 8.6 ± 1.0 kg BM (10%), 3.4 ± 0.6 kg LSTM (6%), and 5.2 ± 0.8 kg FM (21%). This was not significantly different from the CON group losing 7.4 ± 1.0 kg BM (9%), 3.4 ± 0.6 kg LSTM (6%), and 4.0 ± 0.8 FM (17%). Likewise, 1RM decreased equally in both groups. Chair rise and arm curl performance improved significantly more in PRT compared with in CON (p < 0.05).

Interpretation: In this study PRT initiated at CCRT onset did not attenuate loss of LSTM or muscle strength. However, PRT did result in significantly increased functional performance.

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References

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Published

2026-07-10

How to Cite

Lonkvist, C. K., Lønbro, S., Vinther, A., Zerahn, B., Rosenbom, E., Svart, M. V., … Gehl, J. (2026). The effect of progressive resistance training on lean soft tissue mass in head and neck cancer patients during concomitant chemoradiotherapy: the DAHANCA 31 randomized controlled trial. Acta Oncologica, 65, 599–608. https://doi.org/10.2340/1651-226X.2026.45545

Issue

Vol. 65 (2026): Acta Oncologica

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Original article

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Copyright (c) 2026 Camilla K. Lonkvist, Simon Lønbro, Anders Vinther, Bo Zerahn, Eva Rosenbom, Mads Vansted Svart, Morten Lyng Høgild, Hanne Primdahl, Julie Gehl

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This work is licensed under a Creative Commons Attribution 4.0 International License.