Reeves M M, Terranova C O, Eakin E G, Demark-Wahnefried W
School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
Obes Rev. 2014 Sep;15(9):749-68. doi: 10.1111/obr.12190. Epub 2014 May 29.
Obesity has been associated with poor health outcomes in breast cancer survivors. Thus, weight loss is recommended for overweight and obese survivors. We systematically reviewed studies (published up to July 2013) that evaluated behaviourally based, weight loss interventions in women with breast cancer exclusively. Completed randomized trials, single-arm trials and ongoing trials were reviewed. Within-group and between-group differences for weight loss were extracted, as was data on secondary outcomes, i.e. clinical biomarkers, patient-reported outcomes, adverse events. Ten completed randomized trials, four single-arm trials and five ongoing trials were identified. Statistically significant within-group weight loss was observed over periods of 2 to 18 months in 13 of the 14 trials, with six randomized and two single-arm trials observing mean weight loss ≥5%. Clinical biomarkers, psychosocial and patient-reported outcomes were measured in a small number of studies. No serious adverse events were reported. Only two trials assessed maintenance of intervention effects after the end-of-intervention and none reported on cost-effectiveness. The studies included in this review suggest that weight loss is feasible to achieve and is safe in women following treatment for breast cancer. Future studies should assess (and be powered for) a range of biomarker and patient-reported outcomes, and be designed to inform translation into practice.
肥胖与乳腺癌幸存者的不良健康结局相关。因此，建议超重和肥胖的幸存者进行减肥。我们系统回顾了（截至2013年7月发表的）专门评估针对乳腺癌女性基于行为的减肥干预措施的研究。对已完成的随机试验、单臂试验和正在进行的试验进行了回顾。提取了组内和组间的减肥差异数据，以及关于次要结局的数据，即临床生物标志物、患者报告的结局、不良事件。共识别出10项已完成的随机试验、4项单臂试验和5项正在进行的试验。在14项试验中的13项中，观察到在2至18个月的时间内组内体重有统计学意义的下降，其中6项随机试验和2项单臂试验观察到平均体重下降≥5%。少数研究测量了临床生物标志物、心理社会和患者报告的结局。未报告严重不良事件。只有两项试验评估了干预结束后的干预效果维持情况，且均未报告成本效益。本综述纳入的研究表明，乳腺癌治疗后的女性实现减肥是可行的且是安全的。未来的研究应评估（并具备足够的样本量）一系列生物标志物和患者报告的结局，并设计用于指导转化为实践。
