一项回顾性观察队列研究：规定的监督运动方案对接受抗癌治疗的肿瘤患者肿瘤疾病进展的影响。
Effects of a prescribed, supervised exercise programme on tumour disease progression in oncology patients undergoing anti-cancer therapy: a retrospective observational cohort study.
作者信息
Salamon Georgia, Dougherty Daniella, Whiting Lauren, Crawford Gregory B, Stein Brian, Kotasek Dusan
机构信息
Southern Adelaide Palliative Services, Flinders Medical Centre, Adelaide, South Australia, Australia.
LIFT Cancer Care Services, Adelaide, South Australia, Australia.
出版信息
Intern Med J. 2023 Jan;53(1):104-111. doi: 10.1111/imj.15170. Epub 2021 Jul 27.
BACKGROUND
Exercise promotes numerous advantages in both health and disease, and is increasingly being acknowledged to improve overall survival in cancer patients. Preclinical studies indicate a direct effect on tumour behaviour, but human data on the effect of exercise on tumour progression are lacking.
AIMS
To capture preliminary clinical data regarding the impact of a prescribed, supervised exercise programme on cancer disease progression.
METHODS
Retrospective cohort study of 137 matched pairs of patients. All patients referred to LIFT Cancer Care Services (LIFT) supervised exercise programme between 2018 and 2019 were matched with non-LIFT patients from the oncology practice database. Disease progression via staging computed tomography scans ± tumour markers was compared for each match. Secondary outcomes were changes in neutrophil-to-lymphocyte ratio (NLR) and death. Results were analysed by logistical regression and adjusted for potential confounders.
RESULTS
Patients from the LIFT group had a 66% (OR = 0.34, 95% CI 0.19 to 0.61) decreased odds of disease progression and 76% (OR = 0.24, 95% CI 0.12-0.47) decreased odds of death compared with the non-LIFT group. No effect on the number of LIFT sessions on disease progression was demonstrated. The LIFT group had a mean final NLR reading 3.48 (-5.89 to -1.09) lower than the non-LIFT group.
CONCLUSION
Supervised exercise programmes have the potential to significantly improve outcomes in cancer patients due to an effect on tumour progression.
背景
运动在健康和疾病方面都有诸多益处，且其提升癌症患者整体生存率的作用也日益得到认可。临床前研究表明其对肿瘤行为有直接影响，但缺乏人类关于运动对肿瘤进展影响的数据。
目的
获取关于规定的、监督下的运动方案对癌症疾病进展影响的初步临床数据。
方法
回顾性队列研究纳入了 137 对匹配的患者。2018 年至 2019 年期间，所有转诊至 LIFT 癌症护理服务（LIFT）监督运动方案的患者均与肿瘤实践数据库中的非 LIFT 患者相匹配。对每位匹配患者的分期计算机断层扫描（CT）扫描±肿瘤标志物进行疾病进展比较。次要结局为中性粒细胞与淋巴细胞比值（NLR）的变化和死亡。采用逻辑回归分析结果，并针对潜在混杂因素进行调整。
结果
LIFT 组患者疾病进展的几率降低了 66%（比值比[OR] = 0.34，95%置信区间[CI] 0.19 至 0.61），死亡的几率降低了 76%（OR = 0.24，95% CI 0.12 至 0.47），与非 LIFT 组相比。未显示 LIFT 疗程的数量对疾病进展有影响。LIFT 组的平均最终 NLR 读数比非 LIFT 组低 3.48（-5.89 至-1.09）。
结论
监督运动方案由于对肿瘤进展的影响，有可能显著改善癌症患者的结局。
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