Department of Public Health Sciences, College of Medicine, Penn State Milton S. Hershey Medical Center, 600 Centerview Drive, Suite 2200, P.O. Box 855, Hershey, PA 17033-0855, USA.
J Cancer Surviv. 2012 Jun;6(2):172-81. doi: 10.1007/s11764-011-0208-4. Epub 2011 Dec 10.
This study aimed to determine the effect of a moderate, tailored exercise program on health-related quality of life, physical function, and arm volume in women receiving treatment for nonmetastatic breast cancer.
Women who were within 4-12 weeks of surgery for stage I-III breast cancer were randomized to center-based exercise and lymphedema education intervention or patient education. Functional assessment of cancer therapy-breast cancer (FACT-B), 6-min walk, and arm volume were performed at 3-month intervals through 18 months. Repeated measures analysis of covariance was used to model the total meters walked over time, FACT-B scores, and arm volume. Models were adjusted for baseline measurement, baseline affected arm volume, number of nodes removed, age, self-reported symptoms, baseline SF-12 mental and physical component scores, visit, and treatment group.
Of the recruited 104 women, 82 completed all 18 months. Mean age (range) was 53.6 (32-82) years; 88% were Caucasian; 45% were employed full time; 44% were overweight; and 28% obese. Approximately, 46% had breast-conserving surgery; 79% had axillary node dissection; 59% received chemotherapy; and 64% received radiation. The intervention resulted in an average increase of 34.3 ml (SD = 12.8) versus patient education (p = 0.01). Changes in FACT-B scores and arm volumes were not significantly different.
With this early exercise intervention after breast cancer diagnosis, a significant improvement was achieved in physical function, with no decline in health-related quality of life or detrimental effect on arm volume.
Starting a supervised exercise regimen that is tailored to an individual's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning.
本研究旨在确定针对接受非转移性乳腺癌治疗的女性，适度的、定制的运动方案对健康相关生活质量、身体功能和手臂体积的影响。
将手术后 4-12 周的 I-III 期乳腺癌女性随机分为中心基础运动和淋巴水肿教育干预组或患者教育组。在 18 个月内，每 3 个月通过功能性评估癌症治疗-乳腺癌量表（FACT-B）、6 分钟步行和手臂体积进行评估。采用重复测量协方差分析模型来模拟随时间推移的总步行距离、FACT-B 评分和手臂体积。模型根据基线测量值、基线受影响手臂体积、切除淋巴结数量、年龄、自我报告症状、基线 SF-12 心理和生理成分评分、就诊时间和治疗组进行了调整。
在招募的 104 名女性中，82 名完成了所有 18 个月的随访。平均年龄（范围）为 53.6（32-82）岁；88%为白种人；45%全职工作；44%超重；28%肥胖。大约 46%的患者接受了保乳手术；79%的患者接受了腋窝淋巴结清扫术；59%接受了化疗；64%接受了放疗。与患者教育组相比，干预组手臂体积平均增加了 34.3ml（SD=12.8）（p=0.01）。FACT-B 评分和手臂体积的变化无显著差异。
在乳腺癌诊断后进行这种早期的运动干预，可显著改善身体功能，且不会降低健康相关生活质量，也不会对手臂体积产生不利影响。
在乳腺癌手术后 3 个月内开始进行针对个人力量和耐力的监督性运动方案似乎是安全的，并可能加速身体功能的改善。
