Lowe Sonya S, Danielson Brita, Beaumont Crystal, Watanabe Sharon M, Baracos Vickie E, Courneya Kerry S
Department of Symptom Control and Palliative Care, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
J Pain Symptom Manage. 2014 Sep;48(3):322-32. doi: 10.1016/j.jpainsymman.2013.10.012. Epub 2014 Mar 11.
Physical activity has demonstrated benefits for quality of life (QoL) and cancer-related fatigue earlier in the cancer trajectory; however, less is known regarding its role in patients with end-stage cancer.
The primary aim of this study was to examine the association between objectively measured physical activity and QoL in cancer patients with brain metastases.
Patients diagnosed with brain metastases, aged 18 years or older, cognitively intact, and with Palliative Performance Scale scores greater than 30%, were recruited from a multidisciplinary brain metastases clinic. A cross-sectional survey interview assessed self-reported QoL (McGill Quality of Life Questionnaire), self-reported physical function (Late-Life Function and Disability Instrument), and symptoms (Edmonton Symptom Assessment System). Participants wore activPAL™ (PAL Technologies, Ltd., Glasgow, UK) accelerometers recording triaxial movement for seven days during palliative whole brain radiotherapy.
A total of 31 patients were recruited. Median survival was 171 days from time of study consent, with 90% (28 of 31) of deaths by two year follow-up. Participants who stood for 1.6 hours or more per day had better QoL (mean=1.0; 95% confidence interval [CI]=0.1 to 1.9; P=0.034). Participants who stood for 1.6 hours or more per day had better QoL (mean=1.0; 95% CI=0.1 to 1.9; P=0.034). Participants who sat or were supine for 20.7 hours or more per day had better advanced lower extremity functioning (mean=-6.1; 95% CI=-11.9 to -0.3; P=0.040) and total functioning (mean=-10.6; 95% CI=-21.1 to -0.04; P=0.049), but worse depression (mean=2.1; 95% CI=0.3 to 3.9; P=0.028), anxiety (mean=2.8; 95% CI=0.7 to 5.0; P=0.012), and feeling of well-being (mean=1.9; 95% CI=0.2 to 3.6; P=0.028).
Sedentary behavior appears to be associated with better physical functioning but worse psychosocial functioning in cancer patients with brain metastases.
体育活动已被证明在癌症病程早期对生活质量（QoL）和癌症相关疲劳有益；然而，关于其在终末期癌症患者中的作用知之甚少。
本研究的主要目的是探讨客观测量的体育活动与脑转移癌患者生活质量之间的关联。
从多学科脑转移瘤诊所招募年龄在18岁及以上、认知功能完好且姑息治疗表现量表得分高于30%的脑转移瘤患者。一项横断面调查访谈评估了自我报告的生活质量（麦吉尔生活质量问卷）、自我报告的身体功能（晚年功能与残疾量表）和症状（埃德蒙顿症状评估系统）。参与者在姑息性全脑放疗期间佩戴activPAL™（PAL Technologies有限公司，英国格拉斯哥）加速度计记录七天的三轴运动。
共招募了31名患者。从研究同意之时起的中位生存期为171天，两年随访期内90%（31例中的28例）患者死亡。每天站立1.6小时或更长时间的参与者生活质量更好（平均值 = 1.0；95%置信区间[CI] = 0.1至1.9；P = 0.034）。每天站立1.6小时或更长时间的参与者生活质量更好（平均值 = 1.0；95% CI = 0.1至1.9；P = 0.034）。每天坐或仰卧20.7小时或更长时间的参与者下肢功能更好（平均值 = -6.1；95% CI = -11.9至 -0.3；P = 0.040），整体功能更好（平均值 = -10.6；95% CI = -21.1至 -0.04；P = 0.049），但抑郁症状更严重（平均值 = 2.1；95% CI = 0.3至3.9；P = 0.028），焦虑症状更严重（平均值 = 2.8；95% CI = 0.7至5.0；P = 0.012），幸福感更低（平均值 = 1.9；95% CI = 0.2至3.6；P = 0.028）。
久坐行为似乎与脑转移癌患者更好的身体功能相关，但与更差的心理社会功能相关。
