School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
School of Nursing, University of Auckland, Auckland, New Zealand.
Support Care Cancer. 2017 Oct;25(10):3031-3050. doi: 10.1007/s00520-017-3827-0. Epub 2017 Jul 25.
The beneficial effects of exercise in cancer patients are reasonably well-established, although research in this field has predominantly investigated cancer patients in the earlier stages of disease. However, the most recent evidence surrounding exercise interventions in advanced cancer populations has yet to be systematically evaluated. This review critically analyses the safety and feasibility of exercise interventions in patients with advanced cancer.
All randomised, non-randomised and prospective observational trials of exercise training interventions in patients with advanced cancer were included. 'Safety' was defined as the number and severity of reported adverse events during exercise training. 'Feasibility' was determined by participant adherence, attendance and/or study completion rates.
A total of 25 studies involving 1088 patients were included: 16 randomised controlled and nine prospective observational cohort trials. Seven studies included advanced lung cancer patients exclusively, while eight involved patients with various cancer diagnoses. Aerobic exercise was investigated in five studies, resistance training in two studies and combination training (aerobic and resistance) in 14 studies. Six minor adverse events were reported due to exercise. All of these were musculoskeletal in nature, resulting in two participants' withdrawal from the study. Exercise adherence ranged from 65 to 89% but was only described in nine studies. Attendance at each exercise session was described in a further nine studies, ranging from 59 to 100%.
Implementation of exercise interventions appears to be safe and feasible in advanced cancer clinical practice, although targeted studies are required to determine the optimal exercise dose for specific cancer diagnoses.
运动对癌症患者的有益影响已得到充分证实，尽管该领域的研究主要集中在疾病早期的癌症患者上。然而，最近关于晚期癌症患者运动干预的证据尚未得到系统评估。本综述批判性地分析了晚期癌症患者进行运动干预的安全性和可行性。
纳入了所有针对晚期癌症患者的运动训练干预的随机、非随机和前瞻性观察性试验。“安全性”定义为运动训练过程中报告的不良事件的数量和严重程度。“可行性”通过参与者的依从性、出勤率和/或研究完成率来确定。
共纳入了 25 项涉及 1088 名患者的研究：16 项随机对照试验和 9 项前瞻性观察队列试验。7 项研究仅纳入晚期肺癌患者，8 项研究涉及各种癌症诊断。5 项研究调查了有氧运动，2 项研究调查了抗阻运动，14 项研究调查了联合训练（有氧运动和抗阻运动）。因运动导致 6 例轻微不良事件报告。这些都是肌肉骨骼性质的，导致两名参与者退出了研究。运动依从性范围为 65%至 89%，但仅在 9 项研究中进行了描述。另外 9 项研究描述了每次运动课程的出勤率，范围从 59%到 100%。
在晚期癌症临床实践中，实施运动干预似乎是安全且可行的，尽管需要有针对性的研究来确定特定癌症诊断的最佳运动剂量。
