Sedjo Rebecca L, Flatt Shirley W, Byers Tim, 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, Wyatt Holly, Rock Cheryl L
University of Colorado Anschutz Medical Campus, 13001 East 17th Place, MS F519, Aurora, CO, 80045, USA.
University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA.
Support Care Cancer. 2016 Aug;24(8):3285-93. doi: 10.1007/s00520-016-3141-2. Epub 2016 Mar 5.
Comorbid medical conditions are common among breast cancer survivors, contribute to poorer long-term survival and increased overall mortality, and may be ameliorated by weight loss. This secondary analysis evaluated the impact of a weight loss intervention on comorbid medical conditions immediately following an intervention (12 months) and 1-year postintervention (24 months) using data from the Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) trial-a phase III trial which was aimed at and successfully promoted weight loss.
ENERGY randomized 692 overweight/obese women who had completed treatment for early stage breast cancer to either a 1-year group-based behavioral intervention designed to achieve and maintain weight loss or to a less intensive control intervention. Minimal support was provided postintervention. New medical conditions, medical conditions in which non-cancer medications were prescribed, hospitalizations, and emergency room visits, were compared at baseline, year 1, and year 2. Changes over time were analyzed using chi-squared tests, Kaplan-Meier, and logistic regression analyses.
At 12 months, women randomized to the intervention had fewer new medical conditions compared to the control group (19.6 vs. 32.2 %, p < 0.001); however, by 24 months, there was no longer a significant difference. No difference was observed in each of the four conditions for which non-cancer medications were prescribed, hospital visits, or emergency visits at either 12 or 24 months.
These results support a short-term benefit of modest weight loss on the likelihood of comorbid conditions; however, recidivism and weight regain likely explain no benefit at 1-year postintervention follow-up.
合并症在乳腺癌幸存者中很常见，会导致较差的长期生存率和总体死亡率上升，而体重减轻可能会改善这些情况。这项二次分析利用“运动与营养促进康复及健康（ENERGY）”试验的数据，评估了体重减轻干预措施在干预后即刻（12个月）和干预后1年（24个月）对合并症的影响。ENERGY试验是一项III期试验，旨在并成功促进了体重减轻。
ENERGY试验将692名完成早期乳腺癌治疗的超重/肥胖女性随机分为两组，一组接受为期1年的旨在实现并维持体重减轻的基于群体的行为干预，另一组接受强度较低的对照干预。干预后提供的支持极少。比较了基线、第1年和第2年时新出现的疾病、开具了非癌症药物的疾病、住院情况和急诊就诊情况。使用卡方检验、Kaplan-Meier分析和逻辑回归分析来分析随时间的变化。
在12个月时，随机分配到干预组的女性出现的新疾病比对照组少（19.6%对32.2%，p<0.001）；然而，到24个月时，不再有显著差异。在12个月或24个月时，在开具了非癌症药物的四种疾病、住院就诊或急诊就诊方面均未观察到差异。
这些结果支持适度体重减轻对合并症发生可能性有短期益处；然而，复发和体重反弹可能解释了在干预后1年随访时没有益处的原因。
