乳腺癌患者的居家体育活动：化疗期间和/或化疗后？对心肺适能的影响。一项三臂随机对照试验（APAC）
Home-Based Physical Activity in Patients With Breast Cancer: During and/or After Chemotherapy? Impact on Cardiorespiratory Fitness. A 3-Arm Randomized Controlled Trial (APAC).
作者信息
Vincent François, Deluche Elise, Bonis Joëlle, Leobon Sophie, Antonini Marie-Thérèse, Laval Caroline, Favard Florent, Dobbels Eloïse, Lavau-Denes Sandrine, Labrunie Anaïs, Thuillier Frédéric, Venat Laurence, Tubiana-Mathieu Nicole
机构信息
Department of Physiology, University Hospital, Limoges, France.
Faculty of Medicine, University of Limoges, Limoges, France.
出版信息
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420969818. doi: 10.1177/1534735420969818.
OBJECTIVES
Physical activity (PA) programs are recommended for breast cancer care. However, their modalities remain to be discussed. This study determined the best time to begin a personalized or adapted program based on cardiopulmonary exercise test function. This randomized controlled trial evaluated the effect of home-based adapted PA (APA) performed during or after treatment on cardiorespiratory fitness (CRF) at 12 months.
METHOD
The primary endpoint was the peak oxygen consumption (VO) at 12 months (group A vs C and B vs C). Secondary endpoints included the 6-minute walking test, assessment of muscle strength, fatigue, quality of life, anxiety, and depression, and a questionnaire on PA levels. All tests were evaluated at baseline and at 6 and 12 months. A total of 94 patients with breast cancer were randomized to 3 different groups: group A, performing 6 months of APA during adjuvant care; group B, 6 months of APA after adjuvant care; and group C, 12 months of APA during and after specific care. The program combined 1 resistance session and 2 aerobic sessions per week. Analysis of variance was used for repeated measures, Student's -test or the Mann-Whitney -test for continuous variables, and χ test for binary or categorical variables.
RESULTS
The study assessed 81 participants at 6 months and 73 at 12 months. The majority of patients completed more than 85% of the exercise sessions. The baseline for VO and secondary outcomes did not differ among the groups. VO increased during the exercise period and decreased during the chemotherapy period without APA, but at 12 months no significant difference was observed. The same variation was observed in the 6-minute walking test, with significance at 6 months between A+C versus B ( = .04), but no difference among the groups at 12 months. In the 3 groups, no decreases in other studied parameters were noted, except at 6 months in group B without APA.
CONCLUSION
Home-based APA in breast cancer patients has a positive effect on CRF and physical functions, with no differences based on the timing of this program based on specific cancer treatment.
TRIAL REGISTRATION
ClinicalTrials.gouv.fr (NCT01795612).
目的
建议开展体育活动（PA）项目用于乳腺癌护理。然而，其方式仍有待探讨。本研究确定了基于心肺运动试验功能开始个性化或适应性项目的最佳时间。这项随机对照试验评估了在治疗期间或治疗后进行的居家适应性PA（APA）对12个月时心肺适能（CRF）的影响。
方法
主要终点是12个月时的峰值耗氧量（VO）（A组与C组以及B组与C组比较）。次要终点包括6分钟步行试验、肌肉力量评估、疲劳、生活质量、焦虑和抑郁，以及一份关于PA水平的问卷。所有测试均在基线、6个月和12个月时进行评估。总共94例乳腺癌患者被随机分为3组：A组，在辅助治疗期间进行6个月的APA；B组，在辅助治疗后进行6个月的APA；C组，在特定护理期间及之后进行12个月的APA。该项目每周结合1次抗阻训练和2次有氧运动。采用方差分析进行重复测量，对连续变量采用Student's t检验或Mann-Whitney U检验，对二元或分类变量采用χ²检验。
结果
该研究在6个月时评估了81名参与者，在12个月时评估了73名参与者。大多数患者完成了超过85%的锻炼课程。各组之间VO及次要结局的基线无差异。在无APA的化疗期间VO在运动期间增加而在化疗期间下降，但在12个月时未观察到显著差异。在6分钟步行试验中观察到相同的变化，在6个月时A+C组与B组之间有显著性差异（P = 0.04），但在12个月时各组之间无差异。在3组中，除了在无APA的B组6个月时，未观察到其他研究参数下降。
结论
乳腺癌患者的居家APA对CRF和身体功能有积极影响，基于特定癌症治疗的该项目时间安排并无差异。
试验注册
ClinicalTrials.gouv.fr（NCT01795612）
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