Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Viale Europa, 88100 Catanzaro, Italy.
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", 28100 Novara, Italy.
Int J Mol Sci. 2023 Jan 4;24(2):921. doi: 10.3390/ijms24020921.
Rehabilitation might improve bone health in breast cancer (BC) patients, but the effects on bone biomarkers are still debated. Thus, this meta-analysis of randomized controlled trials (RCTs) aims at characterizing the impact of rehabilitation on bone health biomarkers in BC survivors. On 2 May 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for RCTs assessing bone biomarker modifications induced by physical exercise in BC survivors. The quality assessment was performed with the Jadad scale and the Cochrane risk-of-bias tool for randomized trials (RoBv.2). Trial registration number: CRD42022329766. Ten studies were included for a total of 873 patients. The meta-analysis showed overall significant mean difference percentage decrease in collagen type 1 cross-linked N-telopeptide (NTX) serum level [ES: -11.65 (-21.13, -2.17), = 0.02)] and an increase in bone-specific alkaline phosphatase (BSAP) levels [ES: +6.09 (1.56, 10.62). According to the Jadad scale, eight RCTs were considered high-quality studies. Four studies showed a low overall risk of bias, according to RoBv.2. The significant effects of rehabilitation on bone biomarkers suggested a possible implication for a precision medicine approach targeting bone remodeling. Future research might clarify the role of bone biomarkers monitoring in rehabilitation management of cancer treatment induced bone-loss.
康复可能会改善乳腺癌 (BC) 患者的骨骼健康状况，但关于骨骼生物标志物的影响仍存在争议。因此，本项针对随机对照试验 (RCT) 的荟萃分析旨在描述康复对 BC 幸存者骨骼健康生物标志物的影响。于 2022 年 5 月 2 日，系统地检索了 PubMed、Scopus、Web of Science、Cochrane 和 PEDro，以评估评估 BC 幸存者骨骼生物标志物变化的 RCT。使用 Jadad 量表和 Cochrane 随机试验偏倚风险工具 (RoBv.2) 对研究质量进行评估。试验注册号：CRD42022329766。共纳入 10 项研究，共计 873 例患者。荟萃分析显示，胶原类型 1 交联 N 端肽（NTX）血清水平的总体平均差异百分比降低（ES：-11.65 [-21.13，-2.17]， = 0.02），骨碱性磷酸酶（BSAP）水平升高（ES：+6.09 [1.56，10.62）。根据 Jadad 量表，8 项 RCT 被认为是高质量研究。根据 RoBv.2，有 4 项研究显示整体低偏倚风险。康复对骨骼生物标志物的显著影响表明，针对骨骼重塑的精准医学方法可能具有一定的意义。未来的研究可能会阐明在癌症治疗引起的骨丢失的康复管理中监测骨骼生物标志物的作用。
