University of Alberta, Edmonton, AB.
Curr Oncol. 2008 Dec;15(6):279-85. doi: 10.3747/co.v15i6.378.
Observational studies indicate that physical activity (PA) is strongly associated with improved disease outcomes in colon cancer survivors, but a randomized controlled trial is needed to determine whether the association is causal and whether new policies to promote exercise are justified.
The co.21 Colon Health and Life-Long Exercise Change (challenge) trial undertaken by the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) is designed to determine the effects of a structured pa intervention on outcomes for survivors of high-risk stage II or III colon cancer who have completed adjuvant therapy within the previous 2-6 months.
Trial participants (n = 962) will be stratified by centre, disease stage, body mass index, and performance status, and will be randomly assigned to a structured pa intervention or to general health education materials. The pa intervention will consist of a behavioural support program and supervised pa sessions delivered over a 3-year period, beginning with regular face-to-face sessions and tapering to less frequent face-to-face or telephone sessions. The primary endpoint is disease-free survival. Important secondary endpoints include multiple patient-reported outcomes, objective physical functioning, biologic correlative markers, and an economic analysis.
Cancer survivors and cancer care professionals are interested in the potential role of PA to improve multiple disease-related outcomes, but a randomized controlled trial is needed to provide compelling evidence to justify changes in health care policies and practice.
观察性研究表明,体力活动(PA)与结肠癌幸存者改善疾病结局密切相关,但需要进行随机对照试验来确定这种关联是否具有因果关系,以及是否有新的促进运动的政策是合理的。
加拿大国家癌症研究所临床试验组(NCIC CTG)开展的 co.21 结肠健康和终身锻炼改变(挑战)试验旨在确定结构化 PA 干预对接受辅助治疗后 2-6 个月内完成高危 II 期或 III 期结肠癌幸存者结局的影响。
试验参与者(n=962)将根据中心、疾病分期、体重指数和表现状态进行分层,并随机分配到结构化 PA 干预组或一般健康教育材料组。PA 干预将包括行为支持计划和监督 PA 课程,为期 3 年,从定期面对面课程开始,逐渐减少到较少的面对面或电话课程。主要终点是无病生存。重要的次要终点包括多个患者报告的结果、客观身体功能、生物学相关标志物和经济分析。
癌症幸存者和癌症护理专业人员对 PA 改善多种与疾病相关的结局的潜在作用感兴趣,但需要进行随机对照试验来提供有力的证据,以证明改变医疗保健政策和实践是合理的。