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乳腺癌后生活良好™试点试验:一项针对乳腺癌治疗后女性的减肥干预措施。

The Living Well after Breast Cancer™ Pilot Trial: a weight loss intervention for women following treatment for breast cancer.

作者信息

Reeves Marina, Winkler Elisabeth, Mccarthy Nicole, Lawler Sheleigh, Terranova Caroline, Hayes Sandi, Janda Monika, Demark-Wahnefried Wendy, Eakin Elizabeth

机构信息

The University of Queensland, School of Public Health, Cancer Prevention Research Centre, Brisbane, Queensland, Australia.

Icon Cancer Care, Wesley, Queensland, Australia.

出版信息

Asia Pac J Clin Oncol. 2017 Jun;13(3):125-136. doi: 10.1111/ajco.12629. Epub 2016 Nov 10.

Abstract

AIM

Obesity is associated with poor prognosis and risk of treatment side-effects in breast cancer survivors. This pilot study assessed the feasibility, acceptability, safety and efficacy of a telephone-delivered weight loss intervention, among women (BMI 25-40 kg/m ) following treatment for stage I-III breast cancer, on weight loss (primary outcome), quality of life and treatment-related side-effects (vs usual care).

METHODS

Ninety women (mean ± SD age: 55.3 ± 8.7years; BMI: 31.0 ± 4.3 kg/m ; 15.9 ± 2.9 months postdiagnosis), recruited from a state-based cancer registry, were randomized to a weight loss (diet and physical activity) intervention (n = 45) or usual care (n = 45). Data collected at baseline and 6 months included weight, body composition, quality of life, fatigue and body image. Acceptability and satisfaction were assessed in intervention participants.

RESULTS

Oncologists provided consent to contact 82.6% of patients, with 84.1% of those women contacted and eligible consenting to participate. Compared with usual care, mean weight loss was significantly greater in the intervention arm (-3.1 kg [95% CI, -5.4 to -0.7]; -3.7% baseline weight [95% CI, -6.6 to -0.9]), as were reductions in fat mass (-2.1 kg [95% CI, -4.2 to -0.1]) and waist circumference (-4.0 cm [95% CI, -6.6 to -1.3]). No other statistically significant intervention effects were observed. Participants were highly satisfied with the intervention overall and it is timing in relation to diagnosis/treatment. One reported adverse event (musculoskeletal injury) was attributable to the intervention.

CONCLUSIONS

This weight loss intervention was feasible, acceptable, safe and effective for women 1-2 years after a breast cancer diagnosis. The effect of weight loss on quality of life and treatment-related side-effects should be examined further in fully-powered studies.

摘要

目的

肥胖与乳腺癌幸存者的不良预后及治疗副作用风险相关。本试点研究评估了在确诊为Ⅰ - Ⅲ期乳腺癌并接受治疗后的女性(体重指数25 - 40kg/m²)中,通过电话进行的减肥干预在减肥(主要结局)、生活质量及治疗相关副作用方面(与常规护理相比)的可行性、可接受性、安全性和有效性。

方法

从州级癌症登记处招募了90名女性(平均年龄±标准差:55.3±8.7岁;体重指数:31.0±4.3kg/m²;确诊后15.9±2.9个月),随机分为减肥(饮食和体育活动)干预组(n = 45)或常规护理组(n = 45)。在基线和6个月时收集的数据包括体重、身体成分、生活质量、疲劳和身体形象。对干预组参与者进行了可接受性和满意度评估。

结果

肿瘤学家同意联系82.6%的患者,其中84.1%的被联系且符合条件的女性同意参与。与常规护理相比,干预组的平均体重减轻显著更大(-3.1kg[95%置信区间,-5.4至-0.7];占基线体重的-3.7%[95%置信区间,-6.6至-0.9]),脂肪量减少(-2.1kg[95%置信区间,-4.2至-0.1])和腰围减少(-4.0cm[95%置信区间,-6.6至-1.3])也更显著。未观察到其他具有统计学意义的干预效果。参与者对干预总体及其与诊断/治疗相关的时间安排高度满意。有1例报告的不良事件(肌肉骨骼损伤)归因于干预。

结论

这种减肥干预对乳腺癌诊断后1 - 2年的女性是可行、可接受、安全且有效的。减肥对生活质量和治疗相关副作用的影响应在充分有力的研究中进一步探讨。

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