Invernizzi Marco, de Sire Alessandro, Lippi Lorenzo, Venetis Konstantinos, Sajjadi Elham, Gimigliano Francesca, Gennari Alessandra, Criscitiello Carmen, Cisari Carlo, Fusco Nicola
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.
Rehabilitation Unit, "Mons. L. Novarese" Hospital, Vercelli, Italy.
Front Oncol. 2020 Oct 21;10:556718. doi: 10.3389/fonc.2020.556718. eCollection 2020.
Breast cancer fatigue (BCF) is a complex and multidimensional condition characterized by a persistent sense of physical and/or mental stiffness, resulting in a substantial impairment of health-related quality of life in breast cancer survivors. Aim of this prospective cohort study was to evaluate the feasibility and the effectiveness of a 4-week rehabilitation protocol on BCF, muscle mass, strength, physical performance, and quality of life in breast cancer (BC) survivors. We recruited adult BC women with a diagnosis of BCF, according to the International Classification of Diseases 10 criteria, referred to the Outpatient Service for Oncological Rehabilitation of a University Hospital. All participants performed a specific physical exercise rehabilitative protocol consisting of 60-min sessions repeated 2 times/week for 4 weeks. All outcomes were evaluated at the baseline (T0), at the end of the 4-week rehabilitation treatment (T1), and at 2 months follow up (T2). The primary outcome measure was the Brief Fatigue Inventory (BFI); secondary outcomes included: Fat-Free Mass and Fat Mass, assessed by Bioelectrical Impedance Analysis (BIA); Hand Grip Strength Test (HGS); Short Physical Performance Battery (SPPB); 10-meter walking test (10 MWT); 6-min walking test (6 MWT); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Thirty-six women (mean age: 55.17 ± 7.76 years) were enrolled in the study. Significant reduction of BCF was observed both after the 4-week rehabilitation treatment (T1) (BFI: 5.4 ± 1.6 vs. 4.2 ± 1.7; = 0.004) and at the follow-up visit (T2) (BFI: 5.4 ± 1.6 vs. 4.4 ± 1.6; = 0.004). Moreover, significant differences ( < 0.001) HGS, SPPB, 10 MWT, 6 MWT, and EORTC QLQ-C30 were found at T1, while at T2 all the outcome measures were significantly different ( < 0.05) from the baseline. The rehabilitation protocol seemed to be feasible, safe, and effective in reducing BCF, improving muscle mass and function, and improving HRQoL in a cohort of BC survivors. The results of this study could improve awareness of this underestimated disease, suggesting the definition of a specific therapeutic exercise protocol to reduce BCF.
乳腺癌疲劳（BCF）是一种复杂的多维度病症，其特征为持续存在的身体和/或精神僵硬感，这导致乳腺癌幸存者的健康相关生活质量大幅受损。这项前瞻性队列研究的目的是评估一项为期4周的康复方案对乳腺癌（BC）幸存者的BCF、肌肉质量、力量、身体机能和生活质量的可行性和有效性。我们根据国际疾病分类第10版标准，招募了诊断为BCF的成年BC女性，她们被转介到一家大学医院的肿瘤康复门诊服务处。所有参与者都执行了一项特定的体育锻炼康复方案，包括每周重复2次、每次60分钟的训练课程，持续4周。所有结果在基线期（T0）、4周康复治疗结束时（T1）以及2个月随访期（T2）进行评估。主要结局指标是简明疲劳量表（BFI）；次要结局指标包括：通过生物电阻抗分析（BIA）评估的去脂体重和脂肪量；握力测试（HGS）；简短身体机能量表（SPPB）；10米步行测试（10 MWT）；6分钟步行测试（6 MWT）；欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）。36名女性（平均年龄：55.17±7.76岁）参与了该研究。在4周康复治疗后（T1）（BFI：5.4±1.6 vs. 4.2±1.7；P = 0.004）以及随访时（T2）（BFI：5.4±1.6 vs. 4.4±1.6；P = 0.004）均观察到BCF显著降低。此外，在T1时发现HGS、SPPB、10 MWT、6 MWT和EORTC QLQ-C30有显著差异（P<0.001），而在T2时所有结局指标与基线相比均有显著差异（P<0.05）。该康复方案在降低BCF、改善肌肉质量和功能以及提高BC幸存者队列的健康相关生活质量方面似乎是可行、安全且有效的。这项研究的结果可以提高对这种被低估疾病的认识，建议制定特定的治疗性锻炼方案来降低BCF。
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