Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida.
Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri.
Cancer. 2021 Nov 1;127(21):4022-4029. doi: 10.1002/cncr.33787. Epub 2021 Jul 15.
Cancer and its treatment damage the musculoskeletal system and induce neurotoxicity, affecting the key sensory inputs for maintaining balance. The present study describes the pattern of balance impairment and evaluated its association with mortality among US cancer survivors.
Data on a nationally representative sample of cancer survivors from the US National Health and Nutrition Examination Survey from 1999 to 2015 was analyzed. Sensory-specific balance impairment was measured at baseline by the modified Romberg test of standing balance on firm and compliant support surfaces. The linked mortality data were updated through December 31, 2015.
Among 511 cancer survivors, 282 (48.3%) had a balance impairment, predominantly attributing to vestibular dysfunction (251; 89.0% of 282 and 44.5% of 511). A higher prevalence of balance impairment was observed among cancer survivors with advanced age, lower socioeconomic status or educational attainment, body mass index <25 kg/m , and an inactive lifestyle. During up to 16.4 years of follow-up (median, 11.3 years; 5088 person-years), 253 cancer survivors had died. Cancer survivors with a balance impairment had a 63% higher risk of death from all causes (hazard ratio, 1.63; 95% confidence interval [CI], 1.12-2.38) after adjusting for sociodemographic factors, comorbidities, and cancer type. Specifically, those with vestibular dysfunctions had approximately 1.54 (95% CI, 1.05-2.27) times the risk of death compared to those without any balance impairment. These associations were stronger in males than in females.
In a US nationally representative sample of cancer survivors, balance impairment and vestibular dysfunctions were prevalent and associated with heightened all-cause mortality.
癌症及其治疗会损害肌肉骨骼系统并引发神经毒性，从而影响维持平衡的关键感觉输入。本研究描述了平衡障碍的模式，并评估了其与美国癌症幸存者死亡率的关系。
对 1999 年至 2015 年期间美国国家健康和营养检查调查的全国代表性癌症幸存者样本数据进行了分析。在基线时，通过改良的 Romberg 直立平衡测试在坚固和顺应性支撑表面上测量感觉特异性平衡障碍。通过 2015 年 12 月 31 日的更新链接死亡数据。
在 511 名癌症幸存者中，282 名（48.3％）存在平衡障碍，主要归因于前庭功能障碍（251 名；282 名中的 89.0％和 511 名中的 44.5％）。在年龄较大、社会经济地位或教育程度较低、体重指数<25kg/m 和生活方式不活跃的癌症幸存者中，平衡障碍的患病率更高。在长达 16.4 年的随访期间（中位数为 11.3 年；5088 人年），有 253 名癌症幸存者死亡。在校正社会人口因素、合并症和癌症类型后，有平衡障碍的癌症幸存者全因死亡的风险增加了 63％（危险比，1.63；95％置信区间[CI]，1.12-2.38）。具体来说，与没有任何平衡障碍的患者相比，患有前庭功能障碍的患者死亡风险约增加 1.54 倍（95％CI，1.05-2.27）。这些关联在男性中比在女性中更强。
在一个具有美国代表性的癌症幸存者样本中，平衡障碍和前庭功能障碍普遍存在，并与全因死亡率升高有关。
