Schauer Tim, Mazzoni Anne-Sophie, Henriksson Anna, Demmelmaier Ingrid, Berntsen Sveinung, Raastad Truls, Nordin Karin, Pedersen Bente K, Christensen Jesper F
Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Endocr Relat Cancer. 2021 Mar;28(3):191-201. doi: 10.1530/ERC-20-0507.
Exercise training has been hypothesized to lower the inflammatory burden for patients with cancer, but the role of exercise intensity is unknown. To this end, we compared the effects of high-intensity (HI) and low-to-moderate intensity (LMI) exercise on markers of inflammation in patients with curable breast, prostate and colorectal cancer undergoing primary adjuvant cancer treatment in a secondary analysis of the Phys-Can randomized trial (NCT02473003). Sub-group analyses focused on patients with breast cancer undergoing chemotherapy. Patients performed 6 months of combined aerobic and resistance exercise on either HI or LMI during and after primary adjuvant cancer treatment. Plasma taken at baseline, immediately post-treatment and post-intervention was analyzed for levels of interleukin 1 beta (IL1B), IL6, IL8, IL10, tumor-necrosis factor alpha (TNFA) and C-reactive protein (CRP). Intention-to-treat analyses of 394 participants revealed no significant between-group differences. Regardless of exercise intensity, significant increases of IL6, IL8, IL10 and TNFA post-treatment followed by significant declines, except for IL8, until post-intervention were observed with no difference for CRP or IL1B. Subgroup analyses of 154 patients with breast cancer undergoing chemotherapy revealed that CRP (estimated mean difference (95% CI): 0.59 (0.33; 1.06); P = 0.101) and TNFA (EMD (95% CI): 0.88 (0.77; 1); P = 0.053) increased less with HI exercise post-treatment compared to LMI. Exploratory cytokine co-regulation analysis revealed no difference between the groups. In patients with breast cancer undergoing chemotherapy, HI exercise resulted in a lesser increase of CRP and TNFA immediately post-treatment compared to LMI, potentially protecting against chemotherapy-related inflammation.
运动训练被认为可以减轻癌症患者的炎症负担，但运动强度的作用尚不清楚。为此，在Phys-Can随机试验（NCT02473003）的二次分析中，我们比较了高强度（HI）和低至中等强度（LMI）运动对可治愈的乳腺癌、前列腺癌和结直肠癌患者在接受原发性辅助癌症治疗期间炎症标志物的影响。亚组分析聚焦于接受化疗的乳腺癌患者。患者在原发性辅助癌症治疗期间及之后，进行了6个月的HI或LMI有氧和抗阻联合运动。对基线、治疗后即刻和干预后采集的血浆进行分析，检测白细胞介素1β（IL1B）、IL6、IL8、IL10、肿瘤坏死因子α（TNFA）和C反应蛋白（CRP）水平。对394名参与者的意向性分析显示，组间无显著差异。无论运动强度如何，治疗后IL6、IL8、IL10和TNFA均显著升高，随后显著下降（IL8除外），直至干预后，CRP或IL1B无差异。对154名接受化疗的乳腺癌患者的亚组分析显示，与LMI相比，HI运动后治疗后CRP（估计平均差异（95%CI）：0.59（0.33；1.06）；P = 0.101）和TNFA（EMD（95%CI）：0.88（0.77；1）；P = 0.053）升高较少。探索性细胞因子共调节分析显示两组之间无差异。在接受化疗的乳腺癌患者中，与LMI相比，HI运动在治疗后即刻导致CRP和TNFA的升高较少，可能预防化疗相关炎症。
