Lynch S M, Stricker C T, Brown J C, Berardi J M, Vaughn D, Domchek S, Filseth S, Branas A, Weiss-Trainor E, Schmitz K H, Sarwer D B
Cancer Prevention and Control Fox Chase Cancer Center Philadelphia PA USA; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology University of Pennsylvania Philadelphia PA USA.
Abramson Cancer Center University of Pennsylvania Philadelphia PA USA.
Obes Sci Pract. 2017 Mar;3(1):83-94. doi: 10.1002/osp4.98. Epub 2017 Feb 24.
Half of adult cancer survivors under age 50 years are obese. Excess body weight is associated with cancer recurrence, and effective weight loss interventions for younger cancer survivors are needed. Commercially available, online weight loss programmes are readily accessible, but few have been studied in this population. This study employed a single-arm, pre-post intervention (baseline-6 month/baseline-12 month comparisons) to preliminarily explore feasibility, efficacy and safety of an online, commercially available weight loss programme in breast ( = 30) and testicular ( = 16) cancer survivors under age 50 years.
The intervention included three daily components: exercise, nutritional/behavioural modification strategies and health lessons. Intention-to-treat and completers analyses were conducted. Feasibility was measured by participation (number of participants enrolled/number screened), retention (number of participants attending 6/12 month study visit/number of enrolled) and self-reported adherence rates (average of mean percent adherence to each of the three intervention components). Efficacy was assessed by changes in initial weight (percent weight loss). Safety was assessed by adverse events.
The mean participation rate was 42%. The retention rate was 59% at 6 and 49% at 12 months. The adherence rate for all participants (completers/dropouts/lost-to-follow-up) was 50.1% at 6 and 44% at 12 months. Completers reported adherence rates of 68% at 12 months. Study participants lost 5.3% body weight at 12 months; completers lost 9%. Only three unexpected adverse events (unrelated to the intervention) were reported.
Clinically significant weight loss was observed, although retention rates were low. Findings generally support preliminary feasibility, efficacy and safety of this online weight loss programme, and future randomized control trials should be explored.
50岁以下的成年癌症幸存者中有一半肥胖。超重与癌症复发相关,因此需要针对年轻癌症幸存者的有效减肥干预措施。市面上的在线减肥计划很容易获得,但针对这一人群的研究很少。本研究采用单臂干预前后对照(基线与6个月/基线与12个月比较),初步探讨一种在线的、市面上的减肥计划在50岁以下乳腺癌(n = 30)和睾丸癌(n = 16)幸存者中的可行性、有效性和安全性。
干预包括三个每日组成部分:运动、营养/行为改变策略和健康课程。进行意向性分析和完成者分析。可行性通过参与率(登记参与者数量/筛查数量)、留存率(参加6/12个月研究访视的参与者数量/登记数量)和自我报告的依从率(对三个干预组成部分各自平均依从百分比的平均值)来衡量。有效性通过初始体重变化(体重减轻百分比)来评估。安全性通过不良事件来评估。
平均参与率为42%。6个月时的留存率为59%,12个月时为49%。所有参与者(完成者/退出者/失访者)的依从率在6个月时为50.1%,12个月时为44%。完成者报告12个月时的依从率为68%。研究参与者在12个月时体重减轻了5.3%;完成者体重减轻了9%。仅报告了三例意外不良事件(与干预无关)。
尽管留存率较低,但观察到了具有临床意义的体重减轻。研究结果总体上支持这种在线减肥计划的初步可行性、有效性和安全性,应探索未来的随机对照试验。