Ammitzbøll Gunn, Lanng Charlotte, Kroman Niels, Zerahn Bo, Hyldegaard Ole, Kaae Andersen Klaus, Johansen Christoffer, Dalton Susanne Oksbjerg
a Survivorship Unit , Danish Cancer Society Research Center , Copenhagen , Denmark.
b Department of Breast Surgery , Herlev University Hospital , Herlev , Denmark.
Acta Oncol. 2017 Feb;56(2):360-366. doi: 10.1080/0284186X.2016.1268266. Epub 2017 Jan 13.
Lymphoedema is a common late effect after breast cancer (BC) that has no effective cure once chronic. Accumulating evidence supports progressive strength training (PRT) as a safe exercise modality in relation to the onset and exacerbation of lymphoedema. In the 'preventive intervention against LYmphoedema after breast CAncer' (LYCA) feasibility study we examined the feasibility of a program of PRT in the first year after BC to inform a planned randomised controlled trial (RCT).
LYCA was a one-group prospective pilot trial inviting women operated with axillary lymph node dissection for unilateral primary BC. Participants exercised three times a week for 50 weeks (20 weeks supervised followed by 30 weeks home-based exercise). The program ensured slow individualised progression during the exercise program. The primary outcome was feasibility measured by eligibility and recruitment rates, as well as questionnaire-assessed satisfaction and adherence to exercise. Furthermore, we assessed arm interlimb volume difference by water displacement, muscle strength by dynamic and isometric muscle testing and range of movement in the shoulder by goniometry.
In August 2015, eight of 11 eligible patients accepted participation. Two of them dropped out early due to other health issues. The remaining six participants had high exercise adherence through the supervised period, but only three maintained this through the home exercise period. Program satisfaction was high and no serious adverse events from testing or exercising were reported. One participant presented with lymphoedema at 50-week follow-up. Muscle strength markedly increased with supervised exercise, but was not fully maintained through the home exercise period. Range of shoulder movement was not negatively affected by the program.
Recruitment, testing, and exercise in LYCA was safe and feasible. At the 50-week follow-up, there was one case of lymphoedema. The LYCA program will be further tested in a full-scale RCT.
淋巴水肿是乳腺癌（BC）常见的晚期效应，一旦发展为慢性则无法有效治愈。越来越多的证据支持渐进性力量训练（PRT）作为一种与淋巴水肿的发生和加重相关的安全运动方式。在“乳腺癌后淋巴水肿预防干预”（LYCA）可行性研究中，我们考察了乳腺癌后第一年进行PRT计划的可行性，以为一项计划中的随机对照试验（RCT）提供信息。
LYCA是一项单组前瞻性试点试验，邀请因单侧原发性乳腺癌接受腋窝淋巴结清扫术的女性参与。参与者每周锻炼三次，共50周（20周有监督锻炼，随后30周居家锻炼）。该计划确保在锻炼计划期间缓慢且个性化地进展。主要结局是通过入选率和招募率以及问卷评估的满意度和锻炼依从性来衡量的可行性。此外，我们通过排水法评估手臂肢体间体积差异，通过动态和等长肌肉测试评估肌肉力量，并通过测角法评估肩部活动范围。
2015年8月，11名符合条件的患者中有8名接受了参与。其中2人因其他健康问题提前退出。其余6名参与者在有监督的期间锻炼依从性高，但只有3人在居家锻炼期间保持了这一点。计划满意度高，未报告测试或锻炼导致的严重不良事件。1名参与者在50周随访时出现淋巴水肿。在有监督的锻炼期间肌肉力量显著增加，但在居家锻炼期间未完全维持。该计划对肩部活动范围没有负面影响。
LYCA中的招募、测试和锻炼是安全可行的。在50周随访时，有1例淋巴水肿病例。LYCA计划将在全面的RCT中进一步测试。
