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一项在青少年和年轻成人完成急性癌症治疗后进行结构化运动干预的随机对照试验。

A randomized controlled trial of a structured exercise intervention after the completion of acute cancer treatment in adolescents and young adults.

机构信息

Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, Australia.

ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Melbourne, Australia.

出版信息

Pediatr Blood Cancer. 2021 Jan;68(1):e28751. doi: 10.1002/pbc.28751. Epub 2020 Oct 16.

DOI:10.1002/pbc.28751
PMID:33063932
Abstract

BACKGROUND

Cancer treatments are frequently associated with impaired physical fitness, quality of life (QOL), and fatigue, often persisting into survivorship.  Studies in older adults with cancer have demonstrated benefits from exercise; however, this has not been rigorously investigated in adolescents and young adults (AYA). The aim of this study was to determine whether a structured 10-week exercise intervention was associated with improved cardiorespiratory fitness (VO ), fatigue, and QOL in AYA who have recently completed cancer treatment.

METHOD

Forty-three AYA (median age 21 ± 6 years) were randomly assigned to an exercise group (n = 22) or a control group (n = 21). The exercise group received a structured 10-week exercise program comprising progressive aerobic and resistance exercise; the control arm received routine care. VO was measured at baseline, 10 weeks, and six months. Fatigue and QOL were assessed by the FACIT fatigue scale and the PEDS QL, respectively.

RESULTS

Mean VO at baseline was 26.5 ± 7.2 mL.kg .min , which is substantially lower than population norms. The exercise group demonstrated significant improvement in VO at 10 weeks compared with controls (33.8 ± 8.1 vs 29.6 ± 7.6 mL.kg .min , P = 0.0002), but by six months, the difference was no longer significant (32.9 ± 7.0 vs 30.9 ± 11.0 mL.kg .min , P = 0.21). There were no significant differences in fatigue or total QOL scores between groups.

CONCLUSION

Cancer treatment is associated with reduced VO in AYA. Improvement in VO was accelerated by a 10-week exercise program; however, no significant benefit was observed in QOL or fatigue. The plateau in VO at six months suggests that a maintenance exercise program may be beneficial.

摘要

背景

癌症治疗常导致身体适应性下降、生活质量(QOL)下降和疲劳,且这些问题常持续至癌症幸存者阶段。在患有癌症的老年人中开展的研究显示,运动有诸多益处;然而,此类研究在青少年和年轻成人(AYA)中尚未得到严格验证。本研究旨在确定接受过癌症治疗的 AYA 患者接受为期 10 周的结构性锻炼干预是否能提高心肺适应性(VO )、减轻疲劳感和改善生活质量。

方法

43 名 AYA(中位年龄 21 ± 6 岁)被随机分配至锻炼组(n=22)或对照组(n=21)。锻炼组接受为期 10 周的结构性锻炼计划,包括渐进性有氧和抗阻运动;对照组接受常规护理。在基线、10 周和 6 个月时测量 VO 。使用 FACIT 疲劳量表和 PEDS QL 分别评估疲劳和生活质量。

结果

基线时的平均 VO 为 26.5 ± 7.2 mL·kg-1·min-1,远低于人群正常值。与对照组相比,锻炼组在 10 周时 VO 显著提高(33.8 ± 8.1 比 29.6 ± 7.6 mL·kg-1·min-1,P=0.0002),但 6 个月时差异不再显著(32.9 ± 7.0 比 30.9 ± 11.0 mL·kg-1·min-1,P=0.21)。两组间的疲劳感或总体生活质量评分均无显著差异。

结论

癌症治疗会导致 AYA 的 VO 降低。为期 10 周的运动方案可加快 VO 的提高,但 QOL 或疲劳感并未得到显著改善。6 个月时 VO 达到平台期,提示维持性锻炼方案可能有益。

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