Kessels Ellen, Husson Olga, van der Feltz-Cornelis Christina M
Tilburg University School of Social Sciences, Tranzo Academic Collaborative Centre "Geestdrift", Tilburg University.
Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands.
Neuropsychiatr Dis Treat. 2018 Feb 9;14:479-494. doi: 10.2147/NDT.S150464. eCollection 2018.
The objective of the study was to conduct systematic review and meta-analysis to establish the effect of exercise interventions on cancer-related fatigue (CRF) in cancer survivors, compared to non-exercise intervention controls.
Trials published between January 1st 2000 and August 17th 2016 were included through PubMed database search and search of references. Eligible trials compared the effect of an exercise intervention on CRF compared to non-exercise intervention controls, with CRF as primary outcome and measured by validated self-report questionnaire, in cancer survivors not receiving palliative care. We evaluated risk of bias of individual trials following Cochrane Quality criteria. We performed a random-effects meta-analysis in the low risk of bias trials with intervention type, exercise intensity, adherence, and cancer type as moderators, and also performed meta-regression analyses and a sensitivity analysis including the high risk of bias trials.
Out of 274 trials, 11 met the inclusion criteria, of which six had low risk of bias. Exercise improved CRF with large effect size (Cohen's 0.605, 95% CI 0.235-0.975) with no significant difference between types of cancer. Aerobic exercise (Δ=1.009, CI 0.222-1.797) showed a significantly greater effect than a combination of aerobic and resistance exercises (Δ=0.341, CI 0.129-0.552). Moderator and meta-regression analyses showed high adherence yielding best improvements.
Exercise has a large effect on CRF in cancer survivors. Aerobic interventions with high adherence have the best result.
本研究的目的是进行系统评价和荟萃分析，以确定与非运动干预对照组相比，运动干预对癌症幸存者癌症相关疲劳（CRF）的影响。
通过PubMed数据库搜索和参考文献搜索纳入2000年1月1日至2016年8月17日发表的试验。符合条件的试验比较了运动干预与非运动干预对照组对CRF的影响，以CRF作为主要结局，并通过经过验证的自我报告问卷进行测量，研究对象为未接受姑息治疗的癌症幸存者。我们按照Cochrane质量标准评估了各个试验的偏倚风险。我们在低偏倚风险试验中进行了随机效应荟萃分析，将干预类型、运动强度、依从性和癌症类型作为调节因素，还进行了荟萃回归分析和敏感性分析，包括高偏倚风险试验。
在274项试验中，11项符合纳入标准，其中6项偏倚风险较低。运动改善了CRF，效应量较大（Cohen's d =0.605，95%CI 0.235 - 0.975），不同癌症类型之间无显著差异。有氧运动（Δ=1.009，CI 0.222 - 1.797）的效果显著大于有氧运动与抗阻运动相结合（Δ=0.341，CI 0.129 - 0.552）。调节因素和荟萃回归分析表明，高依从性产生的改善效果最佳。
运动对癌症幸存者的CRF有很大影响。高依从性的有氧运动效果最佳。
