James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York.
Pacific Cancer Research Consortium National Cancer Institute Community Oncology Research Program (NCORP), Seattle, Washington.
J Am Geriatr Soc. 2019 May;67(5):1005-1011. doi: 10.1111/jgs.15951.
BACKGROUND/OBJECTIVE: Exercise interventions improve anxiety and mood disturbances in patients with cancer. However, studies are limited in older adults with cancer. We assessed the effects of exercise on anxiety, mood, and social and emotional well-being in older patients with cancer during their first 6 weeks of chemotherapy.
Exploratory secondary analysis of a randomized controlled trial (RCT).
Community oncology practices.
Older patients (aged 60 years or older) undergoing chemotherapy (N = 252).
Patients were randomized to Exercise for Cancer Patients (EXCAP) or usual care (control) for the first 6 weeks of chemotherapy. EXCAP is a home-based, low- to moderate-intensity progressive walking and resistance training program.
Analysis of covariance, with study arm as the factor, baseline value as the covariate, and study arm × baseline interaction, was used to evaluate arm effects on postintervention anxiety (State Trait Anxiety Inventory [STAI]), mood (Profile of Mood States [POMS]), and social and emotional well-being (Functional Assessment of Cancer Therapy-General subscales) after 6 weeks.
Median age was 67 years; 77% had breast cancer. Statistically significant group differences were observed in the STAI score (P = .001), POMS score (P = .022), social well-being (P = .002), and emotional well-being (P = .048). For each outcome, EXCAP patients with worse baseline scores had larger improvements at 6 weeks; these improvements were clinically significant for STAI score and social well-being.
Among older cancer patients receiving chemotherapy, a 6-week structured exercise program improved anxiety and mood, especially among those participants with worse baseline symptoms. Additional RCTs are needed to confirm these findings and evaluate the appropriate exercise prescription for managing anxiety, mood, and well-being in this patient population. J Am Geriatr Soc 67:1005-1011, 2019.
背景/目的：运动干预可改善癌症患者的焦虑和情绪障碍。然而，针对老年癌症患者的研究有限。我们评估了在癌症患者化疗的前 6 周内，运动对他们的焦虑、情绪以及社交和情感健康的影响。
随机对照试验（RCT）的探索性二次分析。
社区肿瘤学实践。
接受化疗的老年患者（年龄≥60 岁）（N=252）。
患者随机分配至癌症患者运动（EXCAP）组或常规护理（对照组），接受化疗的前 6 周。EXCAP 是一种基于家庭的、低到中等强度的渐进式步行和阻力训练计划。
采用协方差分析，以研究臂为因子，以基线值为协变量，研究臂×基线交互作用为协变量，评估干预后 6 周时手臂对焦虑（状态特质焦虑量表[STAI]）、情绪（心境状态问卷[POMS]）和社交及情感健康（癌症治疗功能评估-一般量表）的影响。
中位年龄为 67 岁，77%患有乳腺癌。在 STAI 评分（P=0.001）、POMS 评分（P=0.022）、社交健康（P=0.002）和情感健康（P=0.048）方面，两组间存在统计学显著差异。对于每个结果，基线评分较差的 EXCAP 患者在 6 周时的改善更大；STAI 评分和社交健康的改善具有临床意义。
在接受化疗的老年癌症患者中，为期 6 周的结构化运动方案改善了焦虑和情绪，尤其是基线症状较差的患者。需要进一步的 RCT 来证实这些发现，并评估针对该患者群体管理焦虑、情绪和健康的适当运动处方。美国老年医学会 67:1005-1011, 2019。
