运动和与健康相关的体能预测乳腺癌患者完成化疗的情况：两项多中心试验的汇总分析。
Exercise and health-related fitness predictors of chemotherapy completion in breast cancer patients: pooled analysis of two multicenter trials.
机构信息
University of Alberta, Edmonton, AB, Canada.
Alberta Health Services, Calgary, AB, Canada.
出版信息
Breast Cancer Res Treat. 2021 Jul;188(2):399-407. doi: 10.1007/s10549-021-06205-8. Epub 2021 Mar 29.
PURPOSE
Achieving a higher chemotherapy completion rate is associated with better outcomes in breast cancer patients. We examined the role of exercise and health-related fitness variables in predicting chemotherapy completion in early stage breast cancer patients.
METHODS
We pooled data from two large, multicenter, exercise trials that obtained baseline (pre-chemotherapy) measures of exercise and health-related fitness in 543 breast cancer patients initiating adjuvant chemotherapy. Assessments included body composition, cardiovascular fitness, muscular strength, patient-reported physical functioning, and self-reported exercise behavior. Chemotherapy completion was assessed as the average relative dose intensity (RDI) for the originally planned regimen. We used logistic regression analyses with a two-sided p value of < 0.05 to estimate the associations between the predictors and an RDI of ≥ 85%.
RESULTS
Overall, 432 of 543 (79.6%) breast cancer patients received an RDI of ≥ 85%. In logistic regression analyses adjusted for significant covariates, patients in the highest 20% vs. lowest 80% of absolute VO were significantly more likely to complete ≥ 85% RDI (89.0% vs. 77.2%; OR 2.06, 95% CI 1.07-3.96, p = 0.031). Moreover, patients in the highest 80% vs. lowest 20% of absolute chest strength were significantly more likely to complete ≥ 85% RDI (81.5% vs. 71.4%; OR 1.80, 95% CI 1.09-2.98, p = 0.021).
CONCLUSIONS
In these exploratory analyses, higher baseline (pre-chemotherapy) cardiovascular fitness and muscular strength were associated with higher rates of chemotherapy completion in early stage breast cancer patients. Aerobic and/or strength training interventions that increase cardiovascular fitness and muscular strength prior to chemotherapy for breast cancer may improve treatment tolerability and outcomes.
CLINICAL TRIAL REGISTRATION
START: NCT00115713, June 24, 2005; CARE: NCT00249015, November 7, 2005 ( http://clinicaltrials.gov ).
目的
提高化疗完成率与乳腺癌患者的预后改善相关。本研究旨在探讨运动和健康相关体能变量在预测早期乳腺癌患者化疗完成情况中的作用。
方法
我们汇总了两项大型、多中心、运动试验的数据，这两项试验共纳入 543 例接受辅助化疗的早期乳腺癌患者，在化疗前（基线）评估了运动和健康相关体能。评估内容包括身体成分、心血管健康、肌肉力量、患者报告的身体功能以及自我报告的运动行为。化疗完成情况评估为原计划方案的平均相对剂量强度（RDI）。我们采用双侧 p 值<0.05 的逻辑回归分析来估计预测因素与 RDI≥85%的关联。
结果
总体而言，543 例乳腺癌患者中有 432 例（79.6%）的 RDI≥85%。在调整了显著协变量的逻辑回归分析中，绝对 VO 最高的 20%与最低的 80%患者完成≥85%RDI 的可能性显著更高（89.0% vs. 77.2%；OR 2.06，95%CI 1.07-3.96，p=0.031）。此外，绝对胸部力量最高的 80%与最低的 20%患者完成≥85%RDI 的可能性显著更高（81.5% vs. 71.4%；OR 1.80，95%CI 1.09-2.98，p=0.021）。
结论
在这些探索性分析中，基线（化疗前）时较高的心血管健康和肌肉力量与早期乳腺癌患者更高的化疗完成率相关。在乳腺癌化疗前进行有氧运动和/或力量训练干预，以提高心血管健康和肌肉力量，可能会改善治疗耐受性和结局。
临床试验注册
START：NCT00115713，2005 年 6 月 24 日；CARE：NCT00249015，2005 年 11 月 7 日（http://clinicaltrials.gov）。
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