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SEHNeCa 随机临床试验方案,评估头颈部癌症患者的监督锻炼。

Protocol for the SEHNeCa randomised clinical trial assesing Supervised Exercise for Head and Neck Cancer patients.

机构信息

Comprehensive Care Group for Patients With Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903, Barakaldo, Bizkaia, Spain.

AFD Salud. Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, Bizkaia, 48007, Spain.

出版信息

BMC Cancer. 2023 Mar 24;23(1):271. doi: 10.1186/s12885-023-10718-4.

Abstract

OBJECTIVES

To evaluate the effectiveness of an innovative supervised exercise programme to mitigate the loss of lean body mass, functional capacity and quality of life in people with head and neck cancer, as well as to identify the optimal moment to apply it, before or after radiotherapy treatment, compared with the prescription of a physical activity plan carried out autonomously.

METHODS

Patients with squamous cell carcinoma of the head and neck (n = 144), treated with radiotherapy, will be randomly assigned to one of 3 comparison groups: pre-radiotherapy supervised exercise, post-radiotherapy supervised exercise and autonomous exercise, stratifying by human papillomavirus infection and previous surgery. The exercise programme will be carried out in 36 sessions over 12 weeks, combining moderate and high intensity strength and aerobic exercises. The main outcome variable is the change in lean body mass at 6 months measured by bioimpedance, while secondary variables are functional capacity, symptoms, quality of life and adverse effects. Longitudinal generalised mixed models will be used for the analyses of the repeated measurements at 3, 6, and 12 months after baseline.

CONCLUSIONS

The pilot study supports the feasibility and safety of the project. However, as the programme progressed, attendance at the sessions decreased. Strategies will be necessary for increasing attendance, as well as involving the patient in their recovery and other incentives. Follow-up after treatment to assess acute/late toxicity will enable us to know the response to both the exercise programme and its adherence.

TRIAL REGISTRATION

NCT04658706 Date and version identifier: March 1, 2023. Version 1.1.

摘要

目的

评估一项创新的监督性运动方案对减轻头颈部癌症患者瘦体重、功能能力和生活质量下降的有效性,并确定在放疗前或放疗后应用该方案的最佳时机,与自主进行的体育活动计划相比。

方法

将接受放疗的头颈部鳞状细胞癌患者(n=144)随机分为 3 个比较组之一:放疗前监督性运动、放疗后监督性运动和自主运动,并按人乳头瘤病毒感染和先前手术进行分层。运动方案将在 12 周内进行 36 次,结合中等和高强度力量和有氧运动。主要结局变量是 6 个月时通过生物阻抗测量的瘦体重变化,次要变量是功能能力、症状、生活质量和不良反应。将使用纵向广义混合模型对基线后 3、6 和 12 个月的重复测量进行分析。

结论

该初步研究支持该项目的可行性和安全性。然而,随着项目的进展,出席课程的人数减少。有必要采取策略提高出勤率,并让患者参与他们的康复和其他激励措施。治疗后的随访以评估急性/迟发性毒性,将使我们能够了解对运动方案及其依从性的反应。

试验注册

NCT04658706 日期和版本标识符:2023 年 3 月 1 日。版本 1.1。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff88/10037879/a2fd4a761bd6/12885_2023_10718_Fig1_HTML.jpg

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