身体活动、模拟快速饮食和心理干预对癌症生存的影响：随机对照试验的系统评价和荟萃分析。
The effects of physical activity, fast-mimicking diet and psychological interventions on cancer survival: A systematic review and meta-analysis of randomized controlled trials.
机构信息
Institute of Infection, Immunity and Inflammation, Sir Graeme Davies Building, 120 University Place, University of Glasgow, Glasgow G12 8TA, United Kingdom.
University of Glasgow Library, University of Glasgow, Hillhead St, Glasgow G12 8QE, United Kingdom.
出版信息
Complement Ther Med. 2021 Mar;57:102654. doi: 10.1016/j.ctim.2020.102654. Epub 2020 Dec 25.
BACKGROUND
Health professionals are often asked if non-pharmacological interventions prolong life. This review aims to evaluate the effects of physical activity, fast-mimicking diet (FMD) and psychological interventions on survival in all cancers.
METHODS
A systematic review and meta-analysis of randomized controlled trials (RCTs). Only RCTs of physical activity, FMD and psychological interventions (including counselling, cognitive and other psychotherapies) in cancer patients that reported survival outcomes were included.
DATA SOURCES
CENTRAL, MEDLINE, Embase, CINAHL, APA PsycINFO, Web of Science, ICTRP and ClinicalTrials.gov from inception to January 2020 were searched without language restrictions. The protocol was prospectively registered at PROSPERO (CRD42019160944).
RESULTS
Thirty-one RCTs (9 on physical activity and 22 on psychological interventions) were included in the final analysis after evaluation of 60,207 records from our initial search. No eligible RCT on FMD was reported. RCTs on group psychological interventions (41.9 %) and in patients with breast cancer (38.7 %) were the most common. Most evaluated short-term interventions and in primary or adjuvant settings. Only one of 9 (11 %) RCTs on physical activity and 8 of 22 (36 %) RCTs on psychological interventions were associated with improved overall survival. Only group psychological interventions in breast cancer had adequate number of RCTs to allow a meta-analysis to be performed. It demonstrated a trend towards improved overall survival (HR -0.20, 95 %CI -0.49 to 0.10), particularly in RCTs that evaluated long-term (>6 months) therapies (HR -0.29, 95 %CI -0.59 to 0.01).
CONCLUSION
Longer term interventions starting early in the patients' care journey in primary and adjuvant settings have shown the most promise for improving survival. Better designed RCTs including survival outcomes are particularly needed in non-breast cancers.
背景
健康专业人员经常被问到非药物干预是否能延长寿命。本综述旨在评估身体活动、快速模拟饮食（FMD）和心理干预对所有癌症患者生存的影响。
方法
系统评价和随机对照试验（RCT）的荟萃分析。仅纳入了报告生存结果的癌症患者身体活动、FMD 和心理干预（包括咨询、认知和其他心理疗法）的 RCT。
资料来源
CENTRAL、MEDLINE、Embase、CINAHL、APA PsycINFO、Web of Science、ICTRP 和 ClinicalTrials.gov 从成立到 2020 年 1 月的记录，没有语言限制。该方案在 PROSPERO（CRD42019160944）中进行了前瞻性注册。
结果
在对我们最初搜索的 60207 条记录进行评估后，最终纳入了 31 项 RCT（9 项关于身体活动，22 项关于心理干预）进行最终分析。没有关于 FMD 的合格 RCT 报告。群体心理干预（41.9%）和乳腺癌患者（38.7%）的 RCT 最常见。大多数评估短期干预和初级或辅助治疗。9 项关于身体活动的 RCT 中只有 1 项（11%）和 22 项关于心理干预的 RCT 中有 8 项（36%）与改善总体生存率相关。只有乳腺癌的群体心理干预有足够数量的 RCT 进行荟萃分析。它显示出改善总体生存率的趋势（HR-0.20，95%CI-0.49 至 0.10），特别是在评估长期（>6 个月）治疗的 RCT 中（HR-0.29，95%CI-0.59 至 0.01）。
结论
在初级和辅助治疗中尽早开始的长期干预措施最有希望提高生存率。尤其需要在非乳腺癌中设计更好的 RCT 并报告生存结果。
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