University Hospital for Women, Arnold-Heller-Straße 3, Haus 24, 24105, Kiel, Germany.
, Altenholz, Germany.
J Cancer Res Clin Oncol. 2018 Sep;144(9):1785-1792. doi: 10.1007/s00432-018-2686-5. Epub 2018 Jun 25.
Breast cancer is the most common cancer disease of women in industrialized countries. Neurotoxic chemotherapy drugs are known to harm peripheral nerves and cause a chemotherapy-induced peripheral neuropathy (CIPN). CIPN is one of the most common adverse events associated with Paclitaxel chemotherapy and may remain present long after the termination of chemotherapy. Thus, it reduces the patients' quality of life (QoL) both during chemotherapy and onwards, and can impose a danger on breast cancer survivors due to an increased risk of falling and fall-related injuries.
The aim of this randomized-controlled trial (RCT) (n = 36) (IG: intervention group, n = 17) (CG: control group, n = 19) was to determine whether sensorimotor exercises have a positive effect on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy (Paclitaxel).
As a result, we were able to show significant improvements in postural stability in monopedal stance [left leg 16.17 ± 3.67 vs. 21.55 ± 5.33 (p < 0.001) and right leg 15.14 ± 2.30 vs. 20.85 ± 5.05 (p < 0.001)] and in bipedal stance [T1 vs. T0, - 0.49 (IG) vs. + 1.14 (CG) p = 0.039].
These results in posturography correlate with the clinical presentation with intervention group patients scoring significantly better on the Fullerton Advanced Balance Scale [37.71 ± 2.73 vs. 34.47 ± 3.98 (p = 0.004)]. Moderate strength training successfully prevented a strength loss in the IG that was remarkable in the CG (- 1.60 vs. 0.60, p = 0.029). Concerning the psychological parameters assessed via EORTC- and MFI-questionnaires, no significant improvements were found.
Future studies should focus on the correlation of clinical and posturometry findings and subjective QOL such as the long-term-development of CIPN.
乳腺癌是工业化国家女性最常见的癌症疾病。神经毒性化疗药物已知会损害周围神经，并导致化疗引起的周围神经病（CIPN）。CIPN 是与紫杉醇化疗相关的最常见不良事件之一，并且可能在化疗结束后很长时间仍然存在。因此，它降低了患者在化疗期间和之后的生活质量（QoL），并且由于跌倒和与跌倒相关的伤害风险增加，对乳腺癌幸存者构成威胁。
本随机对照试验（RCT）（n=36）（IG：干预组，n=17）（CG：对照组，n=19）的目的是确定感觉运动锻炼是否对接受神经毒性化疗（紫杉醇）的乳腺癌患者的身体和心理参数有积极影响。
结果，我们能够在单腿站立姿势[左腿 16.17±3.67 与 21.55±5.33（p<0.001）和右腿 15.14±2.30 与 20.85±5.05（p<0.001）]和双腿站立姿势[T1 与 T0，-0.49（IG）与+1.14（CG）p=0.039]方面显示出明显的姿势稳定性改善。
这些平衡测试的结果与干预组患者在全面高级平衡量表上的评分明显更好的临床表现相关[37.71±2.73 与 34.47±3.98（p=0.004）]。适度的力量训练成功地防止了 IG 的力量损失，而 CG 的力量损失非常明显（-1.60 与 0.60，p=0.029）。关于通过 EORTC 和 MFI 问卷评估的心理参数，没有发现明显的改善。
未来的研究应侧重于临床和姿势测试结果与主观 QoL（例如 CIPN 的长期发展）的相关性。
