Vasson Marie-Paule, Kwiatkowski Fabrice, Rossary Adrien, Jouvency Sylvie, Mouret-Reynier Marie-Ange, Duclos Martine, Van Praagh-Doreau Isabelle, Travade Armelle, Bignon Yves-Jean
Jean Perrin Comprehensive Cancer Centre, Department of Nutrition, 58 Rue Montalembert, 63011 Clermont-Ferrand, France.
University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, CRNH-Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France.
J Oncol. 2020 May 5;2020:4181850. doi: 10.1155/2020/4181850. eCollection 2020.
A growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion "PACThe," we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the "PACThe" study ( = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention "SPA" receiving a 2-week session of physical training, dietary education, and physiotherapy ( = 57), and the control "CTR" ( = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25-30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose ( < 10), insulin ( < 10), and adiponectin ( < 0.022) plasma levels for both intervention arms, which were more accentuated for the >30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI-95%] = 5.06 [1.66-15.41]; =0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient's initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient's recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities.
越来越多的知识表明,规律的体育活动对乳腺癌患者的管理有很大益处,但很少有研究在其结果中考虑生物学参数。在乳腺癌治疗完成后的前瞻性随机试验“PACThe”中,我们确定了体育活动和营养干预对患者随访一年后的生物学和人体测量状况的影响,并阐明了分配时生物标志物与无病生存率之间的联系。对“PACThe”研究人群(n = 251)中的113名患者进行了生物学参数分析。患者在化疗后被随机分为两组:干预组“SPA”接受为期2周的体育训练、饮食教育和物理治疗(n = 57),对照组“CTR”(n = 56)。在分配时和一年后测定饮食问卷、人体测量指标和血液参数。对生存和复发情况进行了7年的检查。数据被视为BMI的函数,即正常体重者BMI≤25,超重者BMI为25 - 30,肥胖患者BMI>30。在分配时,营养摄入值的大标准差反映出三组中一些患者的饮食不均衡。在一年的随访中,我们注意到两个干预组的葡萄糖(p < 0.01)、胰岛素(p < 0.01)和脂联素(p < 0.022)血浆水平均有所升高,在BMI>30的组中更为明显。使用Cox模型,我们证明睾酮血浆值最高与复发风险增加有关(HR [CI - 95%] = 5.06 [1.66 - 15.41];p = 0.004)。在进行全面的多学科支持和教育干预一年后,我们发现人体测量和生物学变化很少,主要与患者的初始BMI有关。我们强调了血浆睾酮在评估患者复发风险中的重要性。未来的研究将有助于更好地理解这种多学科干预与乳腺癌复发相互作用的机制,并确定最有效的方式。 (注:原文中部分括号内内容缺失,翻译时根据上下文补充完整,实际翻译时需根据准确原文进行)