Cancer Control Program, Lombardi Cancer Center and Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven St. NW, Ste 4100, Washington, DC, 20007, USA.
Breast Cancer Res Treat. 2011 Sep;129(2):521-9. doi: 10.1007/s10549-011-1483-5. Epub 2011 Apr 8.
Physical activity can improve quality of life (QOL) in breast cancer survivors but little is known about associations of physical activity and QOL during active cancer therapy. We examine associations between activity levels and QOL in a large cohort of breast cancer patients. Women with invasive, non-metastatic breast cancer (n=2,279) were enrolled between 2006 and 2009 from a managed care organization; assessment were done during active therapy. A physical activity frequency questionnaire was used to calculate the average weekly metabolic equivalent task (MET) hours spent in moderate and vigorous activity during active treatment. QOL was measured by the Functional Assessment of Cancer Therapy-Breast Cancer. Linear regression models tested cross-sectional associations of QOL and functional well-being with physical activity and covariates [socio-demographics, comorbidity, body mass index (BMI), clinical variables, social support, and assessment timing]. Physical activity had a significant positive unadjusted association with all QOL sub-scales (except emotional well-being) (all P values < 0.01). Overall QOL was 4.6 points higher for women in the highest quartile of moderate and vigorous activity versus women in the lowest quartile (P<0.001). In regression models, higher activity was associated with better overall QOL and functional well-being, controlling for covariates (P<0.05). Increasing BMI was also independently but inversely associated with overall QOL (P<0.001) but did not explain the relationship of activity and QOL. White women reported the higher levels of activity than minority women and activity was associated with QOL for Whites but not for minority women. Greater physical activity is associated with small but clinically meaningful increases in QOL during active breast cancer care therapy for Whites but this effect is not seen for minority women. If confirmed in longitudinal analyses, these differences may have implications for disparities research.
身体活动可以改善乳腺癌幸存者的生活质量（QOL），但对于癌症治疗期间身体活动与 QOL 之间的关联知之甚少。我们研究了大样本乳腺癌患者中活动水平与 QOL 之间的关系。从一家管理式医疗组织招募了 2279 名患有浸润性、非转移性乳腺癌的女性，评估是在积极治疗期间进行的。使用体力活动频率问卷来计算活跃治疗期间中等到剧烈活动的平均每周代谢当量任务（MET）小时数。使用癌症治疗功能评估-乳腺癌问卷来测量 QOL。线性回归模型测试了 QOL 和功能健康与体力活动及协变量（社会人口统计学、合并症、体重指数（BMI）、临床变量、社会支持和评估时间）之间的横断面关联。在未经调整的情况下，体力活动与所有 QOL 子量表（情绪健康除外）均有显著的正相关（所有 P 值均<0.01）。与最低四分位组相比，处于中高强度活动最高四分位组的女性总体 QOL 高 4.6 分（P<0.001）。在回归模型中，在控制了协变量后，较高的活动水平与更好的总体 QOL 和功能健康相关（P<0.05）。BMI 的增加也与总体 QOL 呈独立但相反的关系（P<0.001），但并不能解释活动与 QOL 的关系。白人女性报告的活动水平高于少数族裔女性，活动与白人女性的 QOL 相关，但与少数族裔女性无关。对于白人女性，在积极进行乳腺癌护理治疗期间，较高的身体活动与 QOL 略有但具有临床意义的增加相关，但对于少数族裔女性则没有观察到这种作用。如果在纵向分析中得到证实，这些差异可能对差异研究产生影响。
