Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain.
Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain; Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain.
Cancer Treat Rev. 2018 Nov;70:154-167. doi: 10.1016/j.ctrv.2018.08.012. Epub 2018 Sep 3.
Physical capacity and quality of life (QoL) are typically impaired in children/adolescents with cancer. Our primary objective was to examine the effects of exercise training performed after diagnosis of any type of pediatric cancer on physical capacity-related endpoints, survival, disease relapse and adverse effects.
(a) Search and selection criteria: Systematic review in Pubmed and Web of Science (until August 2018) of randomized controlled trials (RCTs) of exercise interventions in children with cancer during treatment or within one year after its end. (b) Data collection: Two authors independently identified studies meeting inclusion criteria, extracted data, and assessed risk of bias using standardized forms. When needed, we contacted authors to request clarifications or additional data. (c) Statistical Analysis: The pooled standardized mean differences (SMD) were calculated for those endpoints for which a minimum of three RCTs used the same assessment method. We also calculated the pooled odds ratio (OR) of dying or having a tumor relapse.
Eight RCTs (n = 283 patients) were included in the systematic review. Of these, five studies (n = 173) could be meta-analyzed. Exercise training during pediatric cancer treatment significantly improves patients' functional mobility, as assessed with the timed up and down stairs test (SMD: -0.73, p < 0.001) and does not affect mortality (OR: 0.85, p = 0.76) or relapse risk (OR: 0.96, p = 0.94).
Exercise training in children with cancer improves functional mobility. More RCTs analyzing the effects of supervised exercise interventions are needed, as well as the development of a core-set of outcomes in pediatric oncology exercise research.
患有癌症的儿童/青少年通常会出现体能和生活质量（QoL）受损的情况。我们的主要目的是研究在诊断出任何类型的儿科癌症后进行运动训练对与体能相关的终点、生存、疾病复发和不良反应的影响。
（a）搜索和选择标准：在 Pubmed 和 Web of Science 中进行系统综述（截至 2018 年 8 月），以纳入在治疗期间或治疗结束后一年内接受癌症治疗的儿童进行的运动干预的随机对照试验（RCTs）。（b）数据收集：两名作者独立识别符合纳入标准的研究，提取数据，并使用标准化表格评估偏倚风险。如有需要，我们会联系作者以请求澄清或额外的数据。（c）统计分析：对于至少有三项 RCT 使用相同评估方法的终点，计算出汇总标准化均数差（SMD）。我们还计算了死亡或肿瘤复发的汇总优势比（OR）。
纳入了 8 项 RCT（n=283 名患者）进行系统综述。其中，有 5 项研究（n=173）可进行荟萃分析。儿科癌症治疗期间的运动训练显著改善了患者的功能性移动能力，这可通过计时上下楼梯测试进行评估（SMD：-0.73，p<0.001），并且不会影响死亡率（OR：0.85，p=0.76）或复发风险（OR：0.96，p=0.94）。
在癌症患儿中进行运动训练可改善其功能性移动能力。需要更多的 RCT 来分析监督运动干预的效果，同时也需要制定儿科肿瘤运动研究的核心结局集。
