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一项评估运动训练对接受雄激素剥夺治疗的前列腺癌患者身体状况有效性的系统评价。

A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy.

作者信息

Yuan Fan, Wang Yang, Xiao Xiwei, Zhang Xufan, Jing Mingyi, Kamecki Hubert, Tan Yu Guang, Barreras Silvia García, Aragon-Ching Jeanny B, Ma Ziyang, Zhang Peihai, Chang Degui, You Yaodong

机构信息

Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Transl Androl Urol. 2023 Aug 31;12(8):1336-1350. doi: 10.21037/tau-23-272. Epub 2023 Aug 4.

Abstract

BACKGROUND

Androgen deprivation therapy (ADT) is an effective prostate cancer (PCa) treatment strategy that can curb the development or progression of the disease. This review aimed to examine and summarize available systematic reviews/meta-analyses (SRs/MAs) of exercise training on physical condition of PCa patients undergoing ADT.

METHODS

A comprehensive search of 8 databases was conducted for relevant literature published before April 25, 2022 with the language restrictions of Chinese and English. Two reviewers independently assessed the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs using a range of evaluation tools, including A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE).

RESULTS

This review included 8 SRs/MAs which included a total of 94 studies. Ultimately, A total of 51 outcomes was included, regarding 11 different outcome categories. The AMSTAR-2 tool showed that 3 SRs/MAs had moderate methodological quality, 4 SRs/MAs had very low quality, and the remaining 1 had low quality. According to the ROBIS scale, 3 SRs/MAs had a high risk of bias. The PRISMA checklist showed that the primary reporting faults were protocol registration and funding source. The GRADE system was used to analyze the evidence quality of the 51 outcomes, and no high-quality evidence was found. However, moderate-quality evidence indicated that exercise training may improve body composition [by lowering body fat mass (BFM) and body fat rate (BFR)], muscular strength, and quality of life (QoL) in PCa patients undergoing ADT. Low-quality evidence demonstrated that exercise training could improve such symptoms as fatigue, depression, sexual function, and cardiometabolic changes.

CONCLUSIONS

Available evidence suggests that exercise training may be used as an adjuvant treatment for PCa patients undergoing ADT to improve several aspects of general health. Studies with more rigorous designs and larger sample sizes are needed to support our findings with more robust evidence.

摘要

背景

雄激素剥夺疗法(ADT)是一种有效的前列腺癌(PCa)治疗策略,可抑制疾病的发展或进展。本综述旨在审查和总结关于运动训练对接受ADT的PCa患者身体状况影响的现有系统评价/荟萃分析(SRs/MAs)。

方法

对8个数据库进行全面检索,查找2022年4月25日前发表的相关文献,语言限制为中文和英文。两名评价员使用一系列评估工具,包括系统评价评估测量工具(AMSTAR)2、系统评价中的偏倚风险(ROBIS)、系统评价和荟萃分析的首选报告项目(PRISMA)以及推荐分级、评估、制定和评价(GRADE),独立评估纳入的SRs/MAs的方法学质量、偏倚风险、报告质量和证据质量。

结果

本综述纳入了8项SRs/MAs,共包括94项研究。最终,共纳入了51项结局,涉及11个不同的结局类别。AMSTAR-2工具显示,3项SRs/MAs的方法学质量中等,4项SRs/MAs的质量非常低,其余1项质量低。根据ROBIS量表,3项SRs/MAs存在高偏倚风险。PRISMA清单显示,主要报告缺陷是方案注册和资金来源。使用GRADE系统分析了51项结局的证据质量,未发现高质量证据。然而,中等质量证据表明,运动训练可能改善接受ADT的PCa患者的身体成分[通过降低体脂质量(BFM)和体脂率(BFR)]、肌肉力量和生活质量(QoL)。低质量证据表明,运动训练可以改善疲劳、抑郁、性功能和心脏代谢变化等症状。

结论

现有证据表明,运动训练可作为接受ADT的PCa患者的辅助治疗,以改善总体健康的多个方面。需要更严格设计和更大样本量的研究,以更有力的证据支持我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e725/10481197/f48aebd9595f/tau-12-08-1336-f1.jpg

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