U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale, Centre Jean PERRIN, Université Clermont Auvergne, Clermont-Ferrand, France,
U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale, Centre Jean PERRIN, Université Clermont Auvergne, Clermont-Ferrand, France.
Oncology. 2019;96(5):223-234. doi: 10.1159/000499383. Epub 2019 Apr 3.
Physical activity is known to prevent the occurrence of cancer and decrease the risk of breast cancer. At diagnosis of breast cancer, fewer than half of the patients reach the international recommendation for physical activity. However, breast cancer patients, and particularly HER2+ breast cancer patients, are exposed to treatment-induced cardiotoxicity because of a side effect of 2 molecules used in standard therapy to treat these tumors, i.e., anthracycline and trastuzumab. Cardiotoxicity can sometimes lead to discontinuation of the treatment and even to the development of cardiovascular diseases. Exercise is known to protect the cardiovascular system in the healthy population. Consequently, being physically active during treatment appears to be a way to prevent the negative impact of cancer treatment on the heart in this population. In particular, aerobic exercising could have a protective effect against treatment-induced cardiotoxicity. A supervised physical activity program seems to be the best way for breast cancer patients to be active during treatment. However, there is very little information, and in particular a lack of guidelines, on exercising available to patients. The interventional trials that have been conducted on this topic are very heterogeneous and no standard recommendations have been made available for cancer patients thus far. An effective physical activity program needs to take each patient's barriers and motivations into account in order to encourage the practice of physical activity throughout treatment. To ensure the success of the program, it is essential to facilitate adherence and especially maintain motivation. Further studies are needed to determine what practice guidelines oncologists should give their patients.
身体活动可以预防癌症的发生，降低乳腺癌的风险。在乳腺癌确诊时，只有不到一半的患者达到国际推荐的身体活动量。然而，乳腺癌患者，特别是 HER2+乳腺癌患者，由于标准治疗中用于治疗这些肿瘤的两种药物（即蒽环类药物和曲妥珠单抗）的副作用而面临治疗相关的心脏毒性。心脏毒性有时会导致治疗中断，甚至导致心血管疾病的发生。运动已知可以保护健康人群的心血管系统。因此，在治疗期间积极运动似乎是预防癌症治疗对该人群心脏产生负面影响的一种方法。特别是，有氧运动可能对治疗引起的心脏毒性有保护作用。监督下的身体活动计划似乎是乳腺癌患者在治疗期间保持活跃的最佳方式。然而，可供患者参考的关于运动的信息非常有限，特别是缺乏指南。迄今为止，针对该主题进行的干预性试验非常多样化，尚未为癌症患者制定出标准建议。一个有效的身体活动计划需要考虑到每个患者的障碍和动机，以鼓励他们在整个治疗过程中进行身体活动。为了确保计划的成功，必须促进患者的依从性，特别是保持其积极性。需要进一步的研究来确定肿瘤学家应该给他们的患者什么样的实践指南。
