运动对癌症患者疲劳和身体活动的四年影响。
Four-year effects of exercise on fatigue and physical activity in patients with cancer.
机构信息
Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands.
Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands.
出版信息
BMC Med. 2018 Jun 8;16(1):86. doi: 10.1186/s12916-018-1075-x.
BACKGROUND
In the earlier randomized controlled Physical Activity during Cancer Treatment (PACT) study, we found beneficial effects of an 18-week supervised exercise program on fatigue in patients with newly diagnosed breast or colon cancer undergoing adjuvant treatment. The present study assessed long-term effects of the exercise program on levels of fatigue and physical activity 4 years after participation in the PACT study.
METHODS
The original study was a two-armed, multicenter randomized controlled trial comparing an 18-week supervised exercise program to usual care among 204 breast cancer patients and 33 colon cancer patients undergoing adjuvant treatment. Of the 237 PACT participants, 197 participants were eligible and approached to participate in the 4-year post-baseline measurements, and 128 patients responded. We assessed fatigue and physical activity levels at 4 years post-baseline and compared this to levels at baseline, post-intervention (18 weeks post-baseline), and at 36 weeks post-baseline.
RESULTS
Intention-to-treat mixed linear effects model analyses showed that cancer patients in the intervention group reported significantly higher moderate-to-vigorous total physical activity levels (141.46 min/week (95% confidence interval (CI) 1.31, 281.61, effect size (ES) = 0.22) after 4 years compared to the usual care group. Furthermore, cancer patients in the intervention group tended to experience less physical fatigue at 4 years post-baseline compared to the usual care group (- 1.13, 95% CI -2.45, 0.20, ES = 0.22), although the result was not statistically significant.
CONCLUSION
Patients with breast or colon cancer who participated in the 18-week exercise intervention showed significant higher levels of moderate-to-vigorous total physical activity levels and a tendency towards lower physical fatigue levels 4 years post-baseline. Our result indicate that exercising during chemotherapy is a promising strategy for minimizing treatment-related side effects, both short and long term.
TRIAL REGISTRATION
Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on 9 December 2009.
背景
在早期的随机对照物理活动治疗癌症（PACT）研究中，我们发现了 18 周监督锻炼计划对接受辅助治疗的新诊断乳腺癌或结肠癌患者的疲劳有益。本研究评估了锻炼计划对 4 年后参加 PACT 研究的患者的疲劳和体力活动水平的长期影响。
方法
原始研究是一项比较 18 周监督锻炼计划与接受辅助治疗的 204 例乳腺癌患者和 33 例结肠癌患者的常规护理的双臂、多中心随机对照试验。在 237 名 PACT 参与者中，有 197 名符合条件并被邀请参加 4 年后的基线测量，有 128 名患者作出了回应。我们在 4 年后的基线测量中评估了疲劳和体力活动水平，并将其与基线水平、干预后（基线后 18 周）和基线后 36 周进行了比较。
结果
意向治疗混合线性效应模型分析表明，干预组的癌症患者报告的中高强度体力活动总水平显著高于常规护理组（4 年后每周 141.46 分钟（95%置信区间（CI）1.31，281.61，效应大小（ES）=0.22）。此外，与常规护理组相比，干预组的癌症患者在 4 年后的基线后报告的身体疲劳程度较低（-1.13，95%CI-2.45，0.20，ES=0.22），尽管结果无统计学意义。
结论
参加 18 周锻炼干预的乳腺癌或结肠癌患者在 4 年后的基线后显示出更高的中高强度体力活动总水平和身体疲劳程度降低的趋势。我们的结果表明，在化疗期间锻炼是一种有前途的策略，可以最大限度地减少短期和长期的治疗相关副作用。
试验注册
当前对照试验 ISRCTN43801571，荷兰试验注册 NTR2138。试验于 2009 年 12 月 9 日注册。
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