博来霉素、依托泊苷和顺铂化疗治疗睾丸癌患者的身体锻炼：肺和血管内皮功能的探索性分析。
Physical exercise in patients with testicular cancer treated with bleomycin, etoposide and cisplatin chemotherapy: pulmonary and vascular endothelial function-an exploratory analysis.
机构信息
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Department of Pulmonary Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
出版信息
J Cancer Res Clin Oncol. 2023 Dec;149(19):17467-17478. doi: 10.1007/s00432-023-05469-5. Epub 2023 Oct 27.
PURPOSE
Bleomycin, etoposide, and cisplatin combination chemotherapy (BEP) improves the survival of patients with testicular cancer, but is associated with potentially life-threatening toxicities like pneumonitis and thromboembolic events. This study explored the effects of physical exercise in patients with testicular cancer during or after BEP-chemotherapy on pulmonary and vascular endothelial toxicity.
METHODS
In this post hoc analysis of a multicenter randomized clinical trial (NCT01642680), patients with metastatic testicular cancer scheduled to receive BEP-chemotherapy were randomized to a 24-week exercise intervention, initiated during (group A) or after BEP-chemotherapy (group B). Endpoints were pulmonary function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), lung transfer-coefficient and transfer factor for carbon monoxide (KCO, DLCO) and markers of vascular endothelial dysfunction (von Willebrand factor (vWF) and factor VIII).
RESULTS
Thirty patients were included. Post-chemotherapy, patients declined less in FVC, FEV1 and DLCO in group A compared to group B. Post-chemotherapy, vWF and factor VIII were significantly lower in group A compared to group B. After completion of exercise, started either during BEP-chemotherapy or thereafter, no between-group differences were found. At 1-year post-intervention, significant between-group differences were found in favour of group A in DLCO and KCO.
CONCLUSIONS
Patients who exercised during BEP-chemotherapy better preserved FVC, FEV1 and DLCO, measured directly post-chemotherapy and 1-year post-intervention (DLCO, KCO). This coincided with less increase in vWF and factor VIII measured directly post-chemotherapy. These data support a beneficial role of a physical exercise intervention during BEP-chemotherapy on pulmonary and vascular damage in patients with testicular cancer.
TRIAL REGISTRY
Optimal Timing of Physical Activity in Cancer Treatment (ACT) Registry URL: https://clinicaltrials.gov/ct2/show/NCT01642680 .
TRIAL REGISTRATION NUMBER
NCT01642680.
目的
博来霉素、依托泊苷和顺铂联合化疗（BEP）可提高睾丸癌患者的生存率，但与潜在的危及生命的毒性有关，如肺炎和血栓栓塞事件。本研究探讨了睾丸癌患者在接受 BEP 化疗期间或之后进行体育锻炼对肺和血管内皮毒性的影响。
方法
在这项多中心随机临床试验（NCT01642680）的事后分析中，计划接受 BEP 化疗的转移性睾丸癌患者被随机分为 24 周的运动干预组，在 BEP 化疗期间（A 组）或之后（B 组）开始。终点是肺功能（用力肺活量（FVC）、一秒用力呼气量（FEV1）、肺转移系数和一氧化碳转移因子（KCO、DLCO）以及血管内皮功能障碍的标志物（血管性血友病因子（vWF）和因子 VIII）。
结果
共纳入 30 例患者。与 B 组相比，A 组患者在化疗后 FVC、FEV1 和 DLCO 的下降幅度较小。与 B 组相比，A 组患者化疗后 vWF 和因子 VIII 明显较低。完成运动后，无论是在 BEP 化疗期间还是之后开始，两组之间均无差异。在干预后 1 年，A 组在 DLCO 和 KCO 方面明显优于 B 组。
结论
在 BEP 化疗期间进行运动的患者在直接化疗后和干预后 1 年时更好地保留了 FVC、FEV1 和 DLCO，（DLCO、KCO）。这与直接化疗后 vWF 和因子 VIII 的增加相吻合。这些数据支持在睾丸癌患者接受 BEP 化疗期间进行体育锻炼干预对肺和血管损伤的有益作用。
试验注册
癌症治疗中体育活动最佳时机（ACT）注册表网址：https://clinicaltrials.gov/ct2/show/NCT01642680。
试验注册号
NCT01642680。
Zotero 插件