Exercise Medicine Research Institute; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
Exercise Medicine Research Institute; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3):716-731. doi: 10.1016/j.ijrobp.2021.06.034. Epub 2021 Jul 8.
Radiation therapy is a commonly used treatment for prostate cancer; however, the side effects may negatively affect quality of life and cause patients to be less physically active. Although exercise has been shown to mitigate radiation therapy-related fatigue in men with prostate cancer during radiation therapy, other adverse effects of treatment such as physical deconditioning, urinary symptoms, or sexual dysfunction have not been systematically reviewed in this patient population. Thus, the purpose of this review was to investigate the effect of exercise on physical function and treatment-related side effects in men with prostate cancer undergoing radiation therapy.
A systematic literature search was conducted in the PubMed, Embase, CINAHL Plus, SPORTDiscus, and Web of Science databases in December 2020. Included studies were randomized controlled trials examining the effects of aerobic and/or resistance exercise interventions on measures of physical function and treatment-related side effects in prostate cancer patients undergoing radiation therapy. Meta-analysis was performed on outcomes that were reported in 2 or more studies.
Seven publications from 6 randomized controlled trials involving 391 prostate cancer patients were included. Patients had stage I to IV cancer with a Gleason score of ≤6 to 10. Exercise resulted in consistent significant benefits for physical function in terms of cardiovascular fitness (standardized mean difference [SMD], 0.83; 95% confidence interval [CI], 0.31-1.36; P < .01) and muscle function (SMD, 1.30; 95% CI, 0.53-2.07; P < .01). Furthermore, there was a significant positive effect of exercise on urinary toxicity (SMD, -0.71; 95% CI, -1.25 to -0.18; P < .01), but not on intestinal (P = .21) or hormonal toxicity (P = .41), depression (P = .45), or sleep symptoms (P = .88).
Based on the current evidence, exercise in men with prostate cancer undergoing radiation therapy improves physical function and mitigates urinary toxicity. The effect of exercise on other treatment-related side effects are less clear and require further investigation.
放射治疗是治疗前列腺癌的常用方法，但副作用可能会降低生活质量，导致患者身体活动减少。尽管运动已被证明可以减轻前列腺癌患者在放疗期间的放疗相关疲劳，但在该患者人群中，尚未系统地审查治疗的其他不良反应，如身体失健、尿症状或性功能障碍。因此，本研究的目的是探讨运动对接受放疗的前列腺癌患者身体功能和治疗相关副作用的影响。
2020 年 12 月，在 PubMed、Embase、CINAHL Plus、SPORTDiscus 和 Web of Science 数据库中进行了系统的文献检索。纳入的研究为随机对照试验，研究了有氧运动和/或抗阻运动干预对接受放疗的前列腺癌患者身体功能和治疗相关副作用的影响。对 2 项或 2 项以上研究报告的结果进行了荟萃分析。
纳入了 6 项随机对照试验的 7 篇文献，共涉及 391 例前列腺癌患者。患者的癌症分期为 I 期至 IV 期，Gleason 评分为≤6 至 10。运动对心血管健康（标准化均数差[SMD]，0.83；95%置信区间[CI]，0.31-1.36；P<.01）和肌肉功能（SMD，1.30；95%CI，0.53-2.07；P<.01）的身体功能有一致的显著益处。此外，运动对尿毒性（SMD，-0.71；95%CI，-1.25 至-0.18；P<.01）有显著的积极影响，但对肠毒性（P=.21）或激素毒性（P=.41）、抑郁（P=.45）或睡眠症状（P=.88）没有影响。
根据目前的证据，接受放疗的前列腺癌患者进行运动可以改善身体功能并减轻尿毒性。运动对其他治疗相关副作用的影响尚不清楚，需要进一步研究。
