Rock Cheryl L, Flatt Shirley W, Byers Tim E, Colditz Graham A, Demark-Wahnefried Wendy, Ganz Patricia A, Wolin Kathleen Y, Elias Anthony, Krontiras Helen, Liu Jingxia, Naughton Michael, Pakiz Bilgé, Parker Barbara A, Sedjo Rebecca L, Wyatt Holly
Cheryl L. Rock, Shirley W. Flatt, Bilgé Pakiz, and Barbara A. Parker, University of California, San Diego, Moores Cancer Center, La Jolla; Patricia A. Ganz, Jonsson Comprehensive Cancer Center and the Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA; Tim E. Byers, Anthony Elias, Rebecca L. Sedjo, and Holly Wyatt, University of Colorado Denver, Aurora, CO; Graham A. Colditz, Jingxia Liu, and Michael Naughton, Washington University School of Medicine, St Louis, MO; Wendy Demark-Wahnefried and Helen Krontiras, University of Alabama Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL; and Kathleen Y. Wolin, Coeus Health, Scale Down, and Northwestern University, Chicago, IL.
J Clin Oncol. 2015 Oct 1;33(28):3169-76. doi: 10.1200/JCO.2015.61.1095. Epub 2015 Aug 17.
Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date.
In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time.
At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P<.001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P<.001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women.
A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival.
肥胖会增加已确诊并接受乳腺癌治疗的女性全因死亡率、乳腺癌死亡率及合并症的风险。“运动与营养促进康复及健康(ENERGY)研究”是迄今为止针对乳腺癌幸存者开展的规模最大的减肥干预试验。
在这项多中心试验中,692名超重/肥胖女性(平均在早期乳腺癌初次治疗后2年)被随机分配至接受基于小组的行为干预组(辅以电话咨询和定制时事通讯以支持减肥)或强度较低的对照干预组,并进行为期2年的观察。在第6、12、18和24个月测量体重和血压。采用纵向混合模型分析随时间的变化。
在12个月时,干预组平均体重减轻了初始体重的6.0%,对照组为1.5%(P<0.001)。在24个月时,干预组和对照组的平均体重减轻分别为3.7%和1.3%(P<0.001)。观察到干预对身体活动和血压有积极影响。减肥干预在55岁以上女性中比在年轻女性中更有效。
行为减肥干预可使超重/肥胖乳腺癌幸存者实现具有临床意义的体重减轻。这些发现支持有必要开展更多研究,以测试支持持续减肥的方法,并研究有意减肥对乳腺癌复发和生存的潜在益处。