Okada Maki, Meeske Kathleen A, Menteer Jondavid, Freyer David R
Children's Hospital Los Angeles, CA 90027, USA.
J Pediatr Oncol Nurs. 2012 Sep-Oct;29(5):246-52. doi: 10.1177/1043454212451525.
Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.
接受过蒽环类药物治疗的儿童癌症幸存者有患剂量依赖性心肌病的风险。从历史上看，基于循证和共识性建议的综合考量，曾建议对某些旨在保护心脏功能的体育活动加以限制。在洛杉矶儿童医院的生命癌症幸存者与过渡项目中，作者重新评估了他们对接触过蒽环类药物的幸存者的运动建议，这些幸存者无论是否在心肌附近接受过放射治疗。主要目标是为该项目中处于风险中的幸存者制定一致、具体、实用、安全且（尽可能）基于证据的建议。为实现这一目标，作者参考了当前针对儿童癌症幸存者的运动指南，查阅了近期针对相关人群的文献，并获取了该项目儿科心脏病学顾问的意见。由此得出的基于风险的运动建议旨在补充当前已发表的指南，最大化安全运动，并帮助儿童癌症幸存者回归强调整体健康和体育活动的正常生活。本文描述了一个单一机构在修改针对处于风险中的儿童幸存者的运动建议方面的经验，包括方法、研究结果、当前的机构实践建议以及示例教育材料。
