School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin, 130000, China.
Nursing Department, the First Bethune Hospital of Jilin University, Changchun, Jilin, 130021, China.
J Cancer Surviv. 2020 Dec;14(6):878-893. doi: 10.1007/s11764-020-00900-z. Epub 2020 Jun 13.
This study aimed to explore the effects of exercise on post-treatment colorectal cancer survivors through a systematic review and meta-analysis as the current information is limited and controversial.
We searched PubMed, Web of Science, Embase, and Cochrane Library databases for randomized controlled trials that focused on exercise intervention for adult colorectal cancer survivors who had completed primary cancer treatment. We extracted and pooled information regarding psychosocial outcomes, physical functions, body composition, metabolic growth factors, and/or tumor-related biomarkers. All data were assessed by two independent reviewers. The risk of bias was assessed using the Cochrane Collaboration's tool.
A total of 20 studies, which presented data from 1223 post-treatment colorectal cancer survivors, matched the inclusion criteria. Compared with usual care or usual lifestyle, exercise intervention increased VO (n = 107, SMD = 0.72, 95% CI = 0.32 to 1.11, I = 41%, P = 0.0004), reduced fasting insulin levels and insulin resistance (n = 150, SMD = - 0.55, 95% CI = - 0.88 to - 0.23, I = 0%, P = 0.0009; SMD = - 0.62, 95% CI = - 0.95 to - 0.29, I = 0%, P = 0.0002), and decreased levels of sICAM-1. Moderate-intensity exercise was associated with a more pro-inflammatory immune state, resulting in increased oxidative DNA damage. However, no evidence was found for effects of exercise on psychosocial outcomes or body composition.
Our results revealed that exercise could be a feasible and effective option for improving cardiopulmonary fitness, metabolism, and tumor-related biomarkers in post-treatment colorectal cancer survivors.
Given the benefits of exercise for colorectal cancer survivors, they should be encouraged to become more physically active.
本研究旨在通过系统评价和荟萃分析探索运动对治疗后结直肠癌幸存者的影响，因为目前的信息有限且存在争议。
我们检索了 PubMed、Web of Science、Embase 和 Cochrane Library 数据库，以获取针对已完成主要癌症治疗的成年结直肠癌幸存者的运动干预的随机对照试验。我们提取并汇总了有关心理社会结果、身体功能、身体成分、代谢生长因子和/或肿瘤相关生物标志物的信息。所有数据均由两名独立评审员评估。使用 Cochrane 协作工具评估偏倚风险。
共有 20 项研究符合纳入标准，共纳入 1223 名治疗后结直肠癌幸存者的数据。与常规护理或常规生活方式相比，运动干预增加了 VO（n = 107，SMD = 0.72，95%CI = 0.32 至 1.11，I = 41%，P = 0.0004），降低了空腹胰岛素水平和胰岛素抵抗（n = 150，SMD = -0.55，95%CI = -0.88 至 -0.23，I = 0%，P = 0.0009；SMD = -0.62，95%CI = -0.95 至 -0.29，I = 0%，P = 0.0002），并降低了 sICAM-1 水平。中等强度运动与更具促炎免疫状态相关，导致氧化 DNA 损伤增加。然而，没有证据表明运动对心理社会结果或身体成分有影响。
我们的结果表明，运动可能是改善治疗后结直肠癌幸存者心肺功能、代谢和肿瘤相关生物标志物的可行且有效的选择。
鉴于运动对结直肠癌幸存者的益处，应鼓励他们更加积极地参与体育活动。
