Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada, Vancouver, British Columbia, Canada.
Oncology Nutrition, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Oncologist. 2018 Jan;23(1):105-115. doi: 10.1634/theoncologist.2017-0141. Epub 2017 Oct 5.
Randomized trials have established efficacy of supervised exercise training during chemotherapy for breast cancer for numerous health outcomes. The purpose of this study was to assess reach, effectiveness, maintenance, and implementation of an evidence-based exercise and healthy eating program offered within an adjuvant care setting.
SUBJECTS, MATERIALS, AND METHODS: Women receiving adjuvant chemotherapy for breast cancer were given a prescription by their oncologist to participate in the Nutrition and Exercise during Adjuvant Treatment (NExT) program. The NExT program consisted of supervised, moderate-intensity, aerobic and resistance exercise three times a week during adjuvant therapy, followed by a step-down in supervised sessions per week for 20 additional weeks, plus one group-based healthy eating session. Usual moderate-to-vigorous physical activity (MVPA) and health-related quality of life (HRQoL) were assessed by questionnaire at baseline, program completion, and one year later, along with measures of satisfaction and safety.
Program reach encompassed referral of 53% of eligible patients, 78% uptake ( = 73 enrolled), and 78% retention for the 45.0 ± 8.3-week program. During the program, MVPA increased (116 ± 14 to 154 ± 14 minutes per week, = .014) and HRQoL did not change. One year later, MVPA (171 ± 24 minutes per week, = .014) and HRQoL (44 ± 1 to 49 ± 1, < .001) were significantly higher than baseline. Exercise adherence was 60% ± 26% to three sessions per week during treatment. No major adverse events occurred and injury prevalence did not change relative to baseline. Participants were highly satisfied.
This oncologist-referred exercise and healthy eating supportive-care program for breast cancer patients receiving chemotherapy was safe, successful in reaching oncologists and patients, and effective for improving MVPA and maintaining HRQoL.
Despite evidence that exercise is both safe and efficacious at improving physical fitness, quality of life, and treatment side effects for individuals with cancer, lifestyle programming is not offered as standard of cancer care. This study describes an oncologist-referred, evidence-based exercise and healthy eating program offered in collaboration with a university as supportive care to women with breast cancer receiving chemotherapy. The program was well received by oncologists and patients, safe, and relatively inexpensive to operate. Importantly, there was a significant positive impact on physical activity levels and health-related quality of life lasting for 2 years after initiation of therapy.
随机试验已经证实，在乳腺癌化疗期间进行监督下的运动训练对许多健康结果具有疗效。本研究的目的是评估在辅助治疗环境中提供的基于证据的运动和健康饮食计划的可及性、效果、维持和实施情况。
受试者、材料和方法：接受乳腺癌辅助化疗的女性收到其肿瘤医生开具的参加营养与辅助治疗期间的运动（NExT）计划的处方。NExT 计划包括在辅助治疗期间每周三次进行监督下的适度强度有氧运动和抗阻运动，然后每周减少一次监督课程，持续 20 周，外加一次基于小组的健康饮食课程。在基线、计划完成和一年后，通过问卷调查评估了常规的中等至剧烈体力活动（MVPA）和健康相关生活质量（HRQoL），并评估了满意度和安全性的测量。
计划的可及性涵盖了 53%符合条件的患者的转诊，78%（ = 73 名入组）的参与率和 45.0 ± 8.3 周计划的 78%的保留率。在计划期间，MVPA 增加（116 ± 14 分钟/周至 154 ± 14 分钟/周， = .014），HRQoL 没有变化。一年后，MVPA（171 ± 24 分钟/周， = .014）和 HRQoL（44 ± 1 至 49 ± 1， < .001）显著高于基线。治疗期间每周三次运动的依从率为 60% ± 26%。没有发生重大不良事件，相对于基线，受伤发生率没有变化。参与者非常满意。
为接受化疗的乳腺癌患者提供的这种由肿瘤医生转诊的、基于运动和健康饮食的支持性护理计划是安全的，成功地覆盖了肿瘤医生和患者，并有效提高了 MVPA 和维持 HRQoL。
尽管有证据表明，运动在提高身体素质、生活质量和癌症患者治疗副作用方面是安全且有效的，但生活方式计划并未作为癌症护理的标准提供。本研究描述了一种由肿瘤医生转诊的、基于证据的运动和健康饮食计划，与大学合作，作为接受化疗的乳腺癌女性的支持性护理。该计划受到肿瘤医生和患者的欢迎，安全且运营成本相对较低。重要的是，在开始治疗后 2 年内，该计划对体力活动水平和健康相关生活质量产生了显著的积极影响。
