Division of Hematology/Oncology, Vermont Cancer Center, University of Vermont, Burlington, VT, USA.
Breast Cancer Res Treat. 2013 Apr;138(3):909-16. doi: 10.1007/s10549-013-2478-1. Epub 2013 Mar 17.
We examined cardiorespiratory fitness (CRF) levels in early stage breast cancer patients and determined whether CRF differs as a function of adjuvant therapy regimen. A total of 180 early breast cancer patients representing three treatment groups (surgery only, single-, and multi-modality adjuvant therapy) in the Cooper Center Longitudinal Study (CCLS) were studied. A non-cancer control group (n = 180) matched by sex, age, and date of the CCLS visit was included. All subjects underwent an incremental exercise tolerance test to symptom limitation to assess CRF (i.e., peak metabolic equivalents [METs] and time to exhaustion). The mean time from breast cancer diagnosis to exercise tolerance testing was 7.4 ± 6.2 years. In adjusted analyses, time to exhaustion and peak METs were incrementally impaired with the addition of surgery, single-, and multi-modality adjuvant therapy compared to those of matched controls (p = 0.006 and 0.028, respectively). CRF was lowest in the multi-modality group compared to all other groups (all p's < 0.05). Despite being 7 years post-diagnosis, asymptomatic early breast cancer survivors have marked reductions in CRF. Patients treated with multi-modal adjuvant therapy have the greatest impairment in CRF.
我们检测了早期乳腺癌患者的心肺适能（CRF）水平，并确定 CRF 是否因辅助治疗方案的不同而有所差异。共有 180 名早期乳腺癌患者参加了库珀中心纵向研究（CCLS）的三个治疗组（仅手术、单一和多模式辅助治疗）。纳入了由性别、年龄和 CCLS 就诊日期匹配的非癌症对照组（n = 180）。所有受试者均接受递增运动耐量试验至症状限制，以评估 CRF（即峰值代谢当量 [METs] 和衰竭时间）。从乳腺癌诊断到运动耐量测试的平均时间为 7.4 ± 6.2 年。在调整分析中，与匹配对照组相比，手术、单一和多模式辅助治疗后衰竭时间和峰值 METs 逐渐受损（p = 0.006 和 0.028）。与其他所有组相比，多模式组的 CRF 最低（所有 p 值均<0.05）。尽管已经诊断出乳腺癌 7 年，但无症状的早期乳腺癌幸存者的 CRF 明显降低。接受多模式辅助治疗的患者的 CRF 受损最大。
