De Caro E, Fioredda F, Calevo M G, Smeraldi A, Saitta M, Hanau G, Faraci M, Grisolia F, Dini G, Pongiglione G, Haupt R
Department of Cardiology, Giannina Gaslini Children's Hospital, Genoa, Italy.
Arch Dis Child. 2006 Jan;91(1):47-51. doi: 10.1136/adc.2004.071241. Epub 2005 Sep 27.
To evaluate cardiopulmonary exercise tolerance in a large cohort of apparently healthy paediatric cancer survivors in order to determine their participation in sporting activities.
A total of 84 young (<21 years) asymptomatic childhood cancer survivors, who had been exposed to anthracyclines (mean dose 212 mg/m2) and/or chest irradiation (median dose 2000 cGy), with normal left ventricular systolic function at rest (fractional shortening >29%), and 79 healthy controls were studied. Exercise testing was performed on a treadmill ergometer. Gas exchange analysis and derived variables were measured on a breath-by-breath basis. Pulmonary functional evaluation was performed before exercise. Echocardiographic evaluation at rest was performed within one month before the exercise test.
There were no differences in exercise responses between patients and controls. In boys <13 years, mean VO2 max was slightly but significantly lower than in controls. This finding was thought to be a result of decreased physical fitness as all the other exercise parameters were similar to those in the controls.
Results show that apparently healthy survivors of paediatric cancer can take part in dynamic sporting activities if they exhibit a normal response to cardiopulmonary exercise testing, while those that exhibit a reduced VO2 max should be re-evaluated after an aerobic training programme, and should undergo tailored dynamic physical activity if the VO2 max does not normalise.
评估一大群表面健康的儿童癌症幸存者的心肺运动耐力,以确定他们参与体育活动的情况。
共研究了84名年龄小于21岁的无症状儿童癌症幸存者,他们曾接受过蒽环类药物(平均剂量212mg/m²)和/或胸部放疗(中位剂量2000cGy),静息时左心室收缩功能正常(缩短分数>29%),并与79名健康对照者进行比较。在跑步机测力计上进行运动测试。逐次呼吸测量气体交换分析和派生变量。运动前进行肺功能评估。运动测试前一个月内进行静息超声心动图评估。
患者和对照者的运动反应没有差异。在13岁以下的男孩中,平均最大摄氧量略低于对照者,但差异有统计学意义。这一发现被认为是身体素质下降的结果,因为所有其他运动参数与对照者相似。
结果表明,表面健康的儿童癌症幸存者如果对心肺运动测试有正常反应,就可以参加动态体育活动,而最大摄氧量降低的幸存者在进行有氧训练计划后应重新评估,如果最大摄氧量未恢复正常,应进行量身定制的动态体育活动。