Courneya Kerry S, Vardy Janette L, O'Callaghan Christopher J, Friedenreich Christine M, Campbell Kristin L, Prapavessis Harry, Crawford Jennifer J, O'Brien Patti, Dhillon Haryana M, Jonker Derek J, Chua Neil S, Lupichuk Sasha, Sanatani Michael S, Gill Sharlene, Meyer Ralph M, Begbie Stephen, Bonaventura Tony, Burge Matthew E, Turner Jane, Tu Dongsheng, Booth Christopher M
University of Alberta, Edmonton, Alberta, Canada.
University of Sydney, Sydney, New South Wales, Australia.
Cancer Epidemiol Biomarkers Prev. 2016 Jun;25(6):969-77. doi: 10.1158/1055-9965.EPI-15-1267. Epub 2016 Apr 8.
There is strong interest in testing lifestyle interventions to improve cancer outcomes; however, the optimal methods for achieving behavior change in large-scale pragmatic trials are unknown. Here, we report the 1-year feasibility results for exercise behavior change in the Canadian Cancer Trials Group CO.21 (CHALLENGE) Trial.
Between 2009 and 2014, 273 high-risk stage II and III colon cancer survivors from 42 centers in Canada and Australia were randomized to a structured exercise program (SEP; n = 136) or health education materials (HEM; n = 137). The primary feasibility outcome in a prespecified interim analysis was a difference between randomized groups of ≥5 metabolic equivalent task (MET)-hours/week in self-reported recreational physical activity (PA) after at least 250 participants reached the 1-year follow-up. Secondary outcomes included health-related fitness.
The SEP group reported an increase in recreational PA of 15.6 MET-hours/week compared with 5.1 MET-hours/week in the HEM group [mean difference = +10.5; 95% confidence interval (CI) = +3.1-+17.9; P = 0.002]. The SEP group also improved relative to the HEM group in predicted VO2max (P = 0.068), 6-minute walk (P < 0.001), 30-second chair stand (P < 0.001), 8-foot up-and-go (P = 0.004), and sit-and-reach (P = 0.08).
The behavior change intervention in the CHALLENGE Trial produced a substantial increase in self-reported recreational PA that met the feasibility criterion for trial continuation, resulted in objective fitness improvements, and is consistent with the amount of PA associated with improved colon cancer outcomes in observational studies.
The CHALLENGE Trial is poised to determine the causal effects of PA on colon cancer outcomes. Cancer Epidemiol Biomarkers Prev; 25(6); 969-77. ©2016 AACR.
人们对测试生活方式干预措施以改善癌症预后有着浓厚兴趣；然而，在大规模实用性试验中实现行为改变的最佳方法尚不清楚。在此，我们报告加拿大癌症试验组CO.21（挑战）试验中运动行为改变的1年可行性结果。
2009年至2014年期间，来自加拿大和澳大利亚42个中心的273名高危II期和III期结肠癌幸存者被随机分为结构化运动计划组（SEP；n = 136）或健康教育材料组（HEM；n = 137）。在至少250名参与者达到1年随访期后的预先指定的中期分析中，主要可行性结果是随机分组之间自我报告的休闲体育活动（PA）每周代谢当量任务（MET）小时数差异≥5 MET-小时/周。次要结果包括与健康相关的体能。
SEP组报告休闲PA每周增加15.6 MET-小时，而HEM组为每周5.1 MET-小时[平均差异 = +10.5；95%置信区间（CI）= +3.1-+17.9；P = 0.002]。SEP组在预测的最大摄氧量（P = 0.068）、6分钟步行（P < 0.001）、30秒坐立试验（P < 0.001）、8英尺起走试验（P = 0.004）和坐位体前屈试验（P = 0.08）方面相对于HEM组也有所改善。
挑战试验中的行为改变干预使自我报告的休闲PA大幅增加，达到了试验继续进行的可行性标准，带来了客观的体能改善，并且与观察性研究中与改善结肠癌预后相关的PA量一致。
挑战试验有望确定PA对结肠癌预后的因果效应。癌症流行病学、生物标志物与预防；25(6)；969-77。©2016美国癌症研究协会。
