Department of Kinesiology and Health, Wright State University, Dayton, OH.
Maple Tree Cancer Alliance, Dayton, OH.
JCO Oncol Pract. 2022 Jul;18(7):e1170-e1180. doi: 10.1200/OP.21.00690. Epub 2022 Apr 1.
In an attempt to promote the integration of exercise oncology as a standard part of clinical practice, economic evaluations are warranted. Thus, the purpose of this study was to prospectively analyze cost savings of an individualized exercise oncology program when patients were randomly assigned.
For this open-label, randomized, prospective, comparative clinical trial, patients with early-stage breast cancer (stage I-II) were randomly assigned into two groups: the control group (CG, n = 120) and the exercise training group (EX, n = 123). Patients in the exercise intervention group completed 12 weeks of prescribed, individualized exercise that aligned with ACSM exercise guidelines for cancer survivors. The CG received the current standard of care, which includes a resource guide with various options available to the cancer survivor.
In the EX group, all physical fitness measures significantly improved compared with baseline ( < .001), while remaining unchanged for the CG ( > .05). Patients in the CG had the highest total mean health care utilization across all measures (CG: $8,598 US dollars, compared with EX: $6,356 US dollars) for emergency visits, outpatient visits, and office-base visits that were not a part of their treatment plan. At baseline, the mean Eastern Cooperative Oncology Group (ECOG) scores did not significantly differ ( > .05); however, at follow-up, a larger proportion of the EX group had ECOG scores of 0 or 1, compared with the CG ( < .05). Finally, patient-reported outcomes were significantly higher in the exercise group, compared with the CG at the 12-week follow-up ( < .001).
A supervised, individualized 12-week exercise intervention led to significant improvements in fitness parameters and ECOG scores, as well as a decrease in unplanned health care utilization among early-stage breast cancer survivors.
为了推动将运动肿瘤学整合为临床实践的标准部分，有必要进行经济评估。因此，本研究旨在前瞻性分析当患者被随机分配时，个体化运动肿瘤学计划的成本节约。
本项开放标签、随机、前瞻性、对照临床试验纳入了早期乳腺癌（I 期-II 期）患者，他们被随机分配到两组：对照组（CG，n=120）和运动训练组（EX，n=123）。运动干预组的患者完成了 12 周的规定个体化运动，这些运动与 ACSM 癌症幸存者运动指南一致。CG 组接受了当前的标准护理，其中包括一份资源指南，为癌症幸存者提供了各种选择。
在 EX 组，所有体能测量指标与基线相比均显著提高（<0.001），而 CG 组则保持不变（>0.05）。CG 组在所有测量指标中（CG：8598 美元，EX：6356 美元）的急诊、门诊和非治疗计划的门诊就诊的总平均医疗保健利用率最高。基线时，ECOG 评分的平均值没有显著差异（>0.05）；然而，在随访时，EX 组中有更大比例的患者 ECOG 评分为 0 或 1，而 CG 组则较低（<0.05）。最后，与 CG 相比，EX 组的患者在 12 周随访时的报告结果明显更高（<0.001）。
一项监督的、个体化的 12 周运动干预导致了早期乳腺癌幸存者的体能参数和 ECOG 评分的显著改善，以及无计划医疗保健利用率的降低。
