Exercise Medicine Research Institute, and.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
J Natl Compr Canc Netw. 2019 Oct 1;17(10):1211-1220. doi: 10.6004/jnccn.2019.7311.
Androgen deprivation therapy (ADT) in the management of prostate cancer (PCa) results in an array of adverse effects, and exercise is one strategy to counter treatment-related musculoskeletal toxicities. This study assessed the prevalence of exercise responsiveness in men with PCa undergoing ADT in terms of body composition, muscle strength, and physical function.
Prospective analyses were performed in 152 men (aged 43-90 years) with PCa receiving ADT who were engaged in resistance exercise combined with aerobic or impact training for 3 to 6 months. Whole-body lean mass and fat mass (FM), trunk FM, and appendicular skeletal muscle were assessed with dual x-ray absorptiometry; upper and lower body muscle strength were assessed with the one-repetition maximum; and physical function was assessed with a battery of tests (6-m usual, fast, and backward walk; 400-m walk; repeated chair rise; stair climb).
Significant improvements were seen (P<.01) in lean mass (0.4±1.4 kg [range, -2.8 to +4.1 kg]), appendicular skeletal muscle (0.2±0.8 kg [range, -1.9 to +1.9 kg]), and all measures of muscle strength (chest press, 2.9±5.8 kg [range, -12.5 to +37.5 kg]; leg press, 29.2±27.6 kg [range, -50.0 to +140.0 kg]) and physical function (from -0.1±0.5 s [range, +1.3 to -2.1 s] for the 6-m walk; to -8.6±15.2 s [range, +25.2 to -69.7 s] for the 400-m walk). An increase in FM was also noted (0.6±1.8 kg [range, -3.6 to +7.3 kg]; P<.01). A total of 21 men did not exhibit a favorable response in at least one body composition component, 10 did not experience improved muscle strength, and 2 did not have improved physical function. However, all patients responded in at least one of the areas, and 120 (79%) favorably responded in all 3 areas.
Despite considerable heterogeneity, most men with PCa receiving ADT responded to resistance-based multimodal exercise, and therefore our findings indicate that this form of exercise can be confidently prescribed to produce beneficial effects during active treatment.
在前列腺癌（PCa）的治疗中，雄激素剥夺疗法（ADT）会导致一系列不良反应，而运动是对抗治疗相关肌肉骨骼毒性的策略之一。本研究评估了接受 ADT 的 PCa 男性在身体成分、肌肉力量和身体功能方面的运动反应发生率。
对 152 名接受 ADT 的 PCa 男性（年龄 43-90 岁）进行前瞻性分析，他们接受了 3-6 个月的抗阻运动联合有氧或冲击训练。全身去脂体重和脂肪量（FM）、躯干 FM 和四肢骨骼肌通过双能 X 线吸收法进行评估；上、下肢肌肉力量通过 1 次重复最大量进行评估；身体功能通过一系列测试进行评估（6 米常速、快速和后退走；400 米走；重复坐起；爬楼梯）。
（P<.01）观察到身体成分（0.4±1.4kg[范围，-2.8 至+4.1kg]）、四肢骨骼肌（0.2±0.8kg[范围，-1.9 至+1.9kg]）和所有肌肉力量测量值（卧推，2.9±5.8kg[范围，-12.5 至+37.5kg]；腿举，29.2±27.6kg[范围，-50.0 至+140.0kg]）以及身体功能（6 米走步速度从-0.1±0.5s[范围，+1.3 至-2.1s]到 400 米走步速度-8.6±15.2s[范围，+25.2 至-69.7s]）都有显著改善。还观察到 FM 增加（0.6±1.8kg[范围，-3.6 至+7.3kg]；P<.01）。21 名男性在至少一个身体成分指标上没有表现出有利的反应，10 名男性没有增强肌肉力量，2 名男性没有改善身体功能。然而，所有患者在至少一个区域都有反应，120 名（79%）患者在所有 3 个区域都有良好的反应。
尽管存在相当大的异质性，但大多数接受 ADT 的 PCa 男性对基于抗阻的综合运动有反应，因此我们的发现表明，这种形式的运动可以被自信地规定，以在积极治疗期间产生有益的效果。
