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半监督运动训练对肺癌或头颈癌患者健康结局的影响:一项随机对照试验方案

Effects of Semisupervised Exercise Training on Health Outcomes in People With Lung or Head and Neck Cancer: Protocol for a Randomized Controlled Trial.

作者信息

Grigoletto Isis, Cavalheri Vinicius, Gobbo Luis Alberto, Pozo Karina, Maia Filho Enio Rodrigues, Ribeiro Diogo Gonçalves, Ielo Nara, De Lima Fabiano Francisco, Ramos Ercy Mara Cipulo

机构信息

Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil.

Cancer Hospital of Presidente Prudente, Presidente Prudente, São Paulo, Brazil.

出版信息

JMIR Res Protoc. 2023 May 24;12:e43547. doi: 10.2196/43547.

Abstract

BACKGROUND

Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative.

OBJECTIVE

The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer.

METHODS

Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival.

RESULTS

In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024.

CONCLUSIONS

This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival.

TRIAL REGISTRATION

Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43547.

摘要

背景

肺癌或头颈癌以其高发病率和死亡率而闻名。化疗和放疗通常被推荐用于这些恶性肿瘤的癌症治疗;然而,它们会对患者的身体和精神状态产生负面影响。因此,考虑抗阻和有氧运动训练以预防这些负面健康结果是合理的。此外,有几个因素阻碍患者参加门诊运动训练项目,因此,半监督的居家运动训练项目可能被视为一个广为接受的替代方案。

目的

本研究的目的是调查半监督的居家运动训练项目对身体机能、身体成分和自我报告结果的影响;规定的初始癌症治疗剂量的变化;3个月、6个月和9个月时的住院次数;以及原发性肺癌或头颈癌患者的12个月生存率。

方法

参与者将被随机分配到训练组(TG)或对照组(CG)。训练组将在整个癌症治疗期间接受半监督的居家抗阻和有氧运动训练。抗阻训练将使用弹力带(TheraBand)每周进行两次。有氧运动训练(即快走)将每天在户外进行至少20分钟。训练期间使用的设备和工具将予以提供。这项干预将在治疗开始前一周开始,在整个治疗期间进行,并在治疗完成后持续2周。对照组将接受常规护理(即没有正式运动处方的癌症治疗)。评估将在常规癌症治疗开始前2周和治疗完成后2周进行。将收集身体功能(外周肌肉力量、功能运动能力和身体活动)、身体成分和自我报告结果(焦虑和抑郁症状、健康相关生活质量以及与疾病和治疗相关的症状)的测量数据。我们将报告规定的初始癌症治疗剂量的任何变化;3个月、6个月和9个月时的住院次数;以及12个月生存率。

结果

2021年2月,临床试验注册获得批准。该试验的招募和数据收集正在进行中(截至2023年4月,已有20名参与者被随机分组),本研究的结果可能会在2024年底发表。

结论

作为癌症患者的辅助治疗,这种运动训练可能会对所评估的健康结果产生积极影响,超过对照组的任何变化,并防止规定的初始癌症治疗剂量减少。如果这些积极影响得到证实,它们可能会影响住院次数和12个月生存率等长期结果。

试验注册

巴西临床试验注册中心(ReBEC)RBR-5cyvzh9;https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9。

国际注册报告标识符(IRRID):PRR1-10.2196/43547。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfed/10248778/162e215e10e5/resprot_v12i1e43547_fig1.jpg

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