Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland.
Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
BMJ Support Palliat Care. 2020 Dec;10(4):404-410. doi: 10.1136/bmjspcare-2020-002487. Epub 2020 Sep 17.
Exercise is a well-established factor which improves outcomes of oncological patients during curative treatment as well as in cancer survivors. However, the role of physical activity in metastatic disease, due to the deficiency of high-level evidence from prospective clinical trials, remains a partially unexplored field of research. Additionally, no specific guidelines related to exercise for persons with advanced cancer have been developed so far. Unfortunately, this research deficit may effectively prevent physicians from prescribing adequate and safe recommendations on physical activity to their patients. In an attempt to fill this gap in clinical practice, we present here an up-to-date review of potential benefits of exercise interventions in relation to the survival, quality of life and supportive care for patients with metastatic cancer. We also review the data on the safety of physical activity with special emphasis on elderly populations or individuals with bone metastases. Finally, we discuss the most relevant clinical factors that should be considered during exercise qualification. In conclusion, physical activity is an important tool for improving the outcomes of people undergoing anticancer therapy for metastatic disease. However, the training should be tailored individually to the patient's functional status, comorbidities and preferences. Physical activity should become a standard component of every metastatic cancer care plan.
锻炼是一个经过充分证实的因素，它可以改善癌症患者在治疗期间以及癌症幸存者的治疗效果。然而，由于前瞻性临床试验缺乏高级别的证据，体力活动在转移性疾病中的作用仍然是一个部分未被探索的研究领域。此外，目前还没有针对晚期癌症患者的专门的锻炼指南。不幸的是，这一研究不足可能会使医生无法为患者提供足够和安全的体力活动建议。为了填补这一临床实践空白，我们在此介绍了有关运动干预对转移性癌症患者生存、生活质量和支持性护理的潜在益处的最新综述。我们还回顾了有关体力活动安全性的数据，特别强调了老年人群体或有骨转移的个体。最后，我们讨论了在进行运动资格认证时应考虑的最相关的临床因素。总之，体力活动是改善接受转移性疾病抗癌治疗的患者预后的重要工具。然而，训练应该根据患者的功能状态、合并症和偏好进行个体化调整。体力活动应该成为每个转移性癌症护理计划的标准组成部分。
