Singh Favil, Galvão Daniel A, Newton Robert U, Spry Nigel A, Baker Michael K, Taaffe Dennis R
1 Edith Cowan University, Perth, Western Australia, Australia.
2 Genesis Cancer Care, Joondalup, Western Australia, Australia.
Integr Cancer Ther. 2018 Sep;17(3):952-959. doi: 10.1177/1534735418781736. Epub 2018 Jun 11.
Neoadjuvant chemoradiation treatment (CRT) in rectal cancer patients is associated with a reduction in physical capacity, lean mass and increased fatigue. As a countermeasure to these treatment-related adverse effects, we examined the feasibility and preliminary efficacy of a 10-week exercise program during CRT.
Ten rectal cancer patients (7 men, aged 27-70 years, body mass index = 26.4 ± 3.8 kg/m) receiving CRT undertook supervised resistance and aerobic exercise twice weekly. Assessments were undertaken pre- and post-intervention for upper and lower body muscle strength by 1-RM, muscle endurance, physical performance tests, body composition by dual X-ray absorptiometry, quality of life, and fatigue.
There was a significant loss in appendicular skeletal muscle (-1.1 kg, P = .012), and fat mass (-0.8 kg, P = .029) following CRT. Despite the loss in skeletal muscle, leg press ( P = .030) and leg extension ( P = .046) strength improved by 27.2% and 22.7%, respectively, and leg press endurance by 76.7% ( P = .007). Changes in strength were accompanied by improved performance ( P < .05) in 6-m fast walking speed (6.9%) and dynamic balance as determined by the 6-m backwards walk (15.5%). There was minimal change in quality of life and fatigue, and no adverse events related to training.
Exercise during neoadjuvant CRT appears to be feasible and well tolerated in rectal cancer patients and may enhance physical function while minimizing adverse changes in body composition and cancer-related fatigue. These initial findings need to be confirmed in randomized controlled trials.
直肠癌患者的新辅助放化疗（CRT）会导致身体能力下降、瘦体重减少以及疲劳加剧。作为应对这些与治疗相关的不良反应的对策，我们研究了在CRT期间进行为期10周的运动计划的可行性和初步疗效。
10名接受CRT的直肠癌患者（7名男性，年龄27 - 70岁，体重指数 = 26.4 ± 3.8 kg/m）每周接受两次有监督的抗阻和有氧运动。在干预前后进行评估，通过1-RM评估上下肢肌肉力量、肌肉耐力、身体性能测试、通过双能X线吸收法评估身体成分、生活质量和疲劳程度。
CRT后，附属骨骼肌显著减少（-1.1 kg，P = 0.012），脂肪量减少（-0.8 kg，P = 0.029）。尽管骨骼肌减少，但腿举力量（P = 0.030）和腿伸展力量（P = 0.046）分别提高了27.2%和22.7%，腿举耐力提高了76.7%（P = 0.007）。力量的变化伴随着6米快速步行速度（6.9%）和由6米向后步行确定的动态平衡（15.5%）的性能改善（P < 0.05）。生活质量和疲劳程度变化极小，且未出现与训练相关的不良事件。
新辅助CRT期间的运动在直肠癌患者中似乎是可行的且耐受性良好，可能会增强身体功能，同时将身体成分和癌症相关疲劳的不良变化降至最低。这些初步发现需要在随机对照试验中得到证实。
