Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Departments of Oncology, Copenhagen, Denmark.
BJS Open. 2020 Oct;4(5):855-864. doi: 10.1002/bjs5.50337. Epub 2020 Aug 28.
Treatment for cancer of the gastro-oesophageal junction (GOJ) can result in considerable and persistent impairment of physical fitness and health-related quality of life (HRQoL). This controlled follow-up study investigated the feasibility and safety of postoperative exercise training.
Patients with stage I-III GOJ cancer were allocated to 12 weeks of postoperative concurrent aerobic and resistance training (exercise group) or usual care (control group). Changes in cardiorespiratory fitness, muscle strength and HRQoL were evaluated. Adherence to adjuvant chemotherapy, hospitalizations and 1-year overall survival were recorded to assess safety.
Some 49 patients were studied. The exercise group attended a mean of 69 per cent of all prescribed sessions. After exercise, muscle strength and cardiorespiratory fitness were increased and returned to pretreatment levels. At 1-year follow-up, the exercise group had improved HRQoL (+13·5 points, 95 per cent c.i. 2·2 to 24·9), with no change in the control group (+3·7 points, -5·9 to 13·4), but there was no difference between the groups at this time point (+9·8 points, -5·1 to 24·8). Exercise was safe, with no differences in patients receiving adjuvant chemotherapy (14 of 16 versus 16 of 19; relative risk (RR) 1·04, 95 per cent c.i. 0·74 to 1·44), relative dose intensity of adjuvant chemotherapy (mean 57 versus 63 per cent; P = 0·479), hospitalization (7 of 19 versus 6 of 23; RR 1·41, 0·57 to 3·49) or 1-year overall survival (80 versus 79 per cent; P = 0·839) for exercise and usual care respectively.
Exercise in the postoperative period is safe and may have the potential to improve physical fitness in patients with GOJ cancer. No differences in prognostic endpoints or HRQoL were observed. Registration number: NCT02722785 ( https://www.clinicaltrials.gov).
治疗胃食管交界癌（GOJ）可能导致身体机能和健康相关生活质量（HRQoL）的显著和持续下降。这项对照随访研究旨在调查术后运动训练的可行性和安全性。
将 I-III 期 GOJ 癌症患者分为术后同步进行有氧和抗阻训练（运动组）或常规护理（对照组） 12 周。评估心肺功能、肌肉力量和 HRQoL 的变化。记录辅助化疗、住院和 1 年总生存率，以评估安全性。
共 49 例患者入组。运动组参加了所有规定疗程的平均 69%。运动后，肌肉力量和心肺功能得到提高，并恢复到治疗前水平。在 1 年随访时，运动组的 HRQoL 得到改善（+13.5 分，95%置信区间 2.2 至 24.9），而对照组无变化（+3.7 分，-5.9 至 13.4），但两组在此时点无差异（+9.8 分，-5.1 至 24.8）。运动是安全的，接受辅助化疗的患者无差异（16 例中的 14 例与 19 例中的 16 例；相对风险（RR）1.04，95%置信区间 0.74 至 1.44），辅助化疗的相对剂量强度（平均 57%与 63%；P=0.479）、住院（19 例中的 7 例与 23 例中的 6 例；RR 1.41，0.57 至 3.49）或 1 年总生存率（运动组和对照组分别为 80%与 79%；P=0.839）。
术后运动是安全的，可能有潜力改善 GOJ 癌症患者的身体机能。在预后终点或 HRQoL 方面没有观察到差异。注册号：NCT02722785（https://www.clinicaltrials.gov）。
