2970 - Impact of Aerobic Exercise on Positioning Accuracy Guided by AccuTrack in Postoperative Breast Cancer Patients Undergoing Radiotherapy

03:00pm - 04:00pm PT

Hall F

Screen: 16

POSTER

Presenter(s)

Zixuan Liu, - Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi’an,

Z. Liu¹, L. Bo², L. Zhang³, F. Bai³, and L. Zhao⁴; ¹Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi’an, China, ²Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China, Xi'an, Shanxi, China, ³Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, xi'an, Shaanxi, China, ⁴StateKey Laboratory of Holisticntegrative Managementof Gastrointestinal Cancersand Department of RadiationOncology,Xijing Hospital,Fourth Military MedicalUniversity, Xi'an, China

Purpose/Objective(s):

Aerobic exercise may indirectly improve radiotherapy positioning accuracy by enhancing posture, muscle strength, and respiratory control. However, direct evidence is lacking. This study aims to investigate the impact of aerobic exercise on positioning accuracy using AccuTrack in postoperative breast cancer patients undergoing radiotherapy, providing insights for optimizing precision and rehabilitation strategies.

Materials/Methods:

A randomized controlled trial enrolled breast cancer patients receiving IMRT on precision radiation medicine company devices from October 2024 to February 2025. Patients were randomized into Group A (routine care + customized aerobic exercise) and Group B (routine care only). Group A performed low-intensity aerobic exercises (e.g., brisk walking, rope skipping, cycling) three times weekly (30 minutes per session) starting 3 weeks post-surgery until radiotherapy completion, while Group B received only routine daily care without mandatory exercise. During treatment, patients' positioning was guided using China's domestically developed optical surface AccuTrack system, with weekly kilovoltage cone-beam computed tomography (CBCT) for spatial verification. Setup errors were recorded in six directions (translational: X, Y, Z; rotational: Roll, Pitch, Rtn). Ipsilateral limb lymphedema was monitored, and patients' physical and mental states were assessed using the fatigue scale (Borg CR10) and anxiety scale (GAD-7). Assessments were conducted at the start of treatment, mid-treatment, and the final treatment session.

Results:

Thirty patients (median age: 48 [32–65]; breast-conserving surgery: 12; radical mastectomy: 18; right-sided: 14; left-sided: 16) were included. Setup errors in Group A vs. Group B: X-axis (1.31±0.95 vs. 1.98±1.56 mm, P=0.002); Y-axis (1.61±1.24 vs. 2.24±1.36 mm, P=0.004); Z-axis (1.41±0.97 vs. 1.85±1.41 mm, P=0.026).No significant differences were observed in rotational errors: Roll (0.65±0.52° vs. 0.81±0.72°, P=0.161); Pitch (0.81±0.68° vs. 0.70±0.59°, P=0.338); Rtn (0.56±0.49° vs. 0.58±0.51°, P=0.71). Group A had significant improvements in fatigue (mean difference: 4.9 [95% CI: 2.3–7.5]) and anxiety (mean difference: 3.2 [95% CI: 1.1–5.3]) compared to Group B. Lymphedema incidence was similar (5% vs. 7.5%, P=0.65).

Conclusion:

This prospective study is the first to demonstrate that aerobic exercise can effectively improve three-dimensional positioning accuracy in radiotherapy, alleviate fatigue, and reduce the incidence of anxiety. Due to the limited sample size, further validation with larger-scale studies is required.