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运动训练对乳腺癌化疗期间与健康相关的生活质量和功能能力有益:一项随机对照试验。

Exercise Training Benefits Health-Related Quality of Life and Functional Capacity during Breast Cancer Chemotherapy: A Randomized Controlled Trial.

作者信息

Antunes Pedro, Joaquim Ana, Sampaio Francisco, Nunes Célia, Ascensão António, Vilela Eduardo, Teixeira Madalena, Oliveira Jorge, Capela Andreia, Amarelo Anabela, Leão Inês, Marques Cristiana, Viamonte Sofia, Alves Alberto, Esteves Dulce

机构信息

Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, PORTUGAL.

Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, PORTUGAL.

出版信息

Med Sci Sports Exerc. 2024 Apr 1;56(4):600-611. doi: 10.1249/MSS.0000000000003341. Epub 2023 Nov 27.

Abstract

PURPOSE

To examine the effectiveness of a supervised exercise training program (SETP) on health-related quality of life (HRQoL) and functional capacity in women with breast cancer (BC) undergoing chemotherapy.

METHODS

Ninety-three women with early-stage BC were randomly allocated to a SETP plus usual care (exercise, n = 47) or usual care alone (UC, n = 46). The SETP included three sessions per week, combining aerobic and resistance training, conducted concurrently over the chemotherapy. The EORTC Cancer Quality-of-Life-Questionnaire-Core-30 (QLQ-C30) and the BC-specific module (QLQ-BR23) were used to assess HRQoL. Functional capacity was analyzed by maximum voluntary handgrip strength (MVHS) and by the 30-s chair sit-to-stand test (30-s CST). These endpoints were assessed at baseline (t0); middle (t1; after 8 or 12 wk of t0); and at the end of chemotherapy (t2; after 20 wk of t0). Mean changes from baseline were assessed by an intention-to-treat approach.

RESULTS

Mixed linear model analyses showed that Exercise group experienced less deterioration in several domains of QLQ-C30 at t2, including in global health status/QoL (Δ = 9.39 units; P = 0.034), QLQ-C30 summary score (Δ = 8.08 units; P < 0.001), physical (Δ = 15.14 units; P < 0.001), role ( Δ = 21.81 units; P < 0.001), cognitive (Δ = 9.16 units; P = 0.032) and social functioning (Δ = 11.67 units; P = 0.038), compared with the UC group. Similarly, Exercise group exhibited significant lower levels of fatigue (Δ = -20.19 units; P < 0.001) and appetite loss (Δ = -13.69 units; P = 0.034), compared with the UC group. Significant between-group differences were observed on MVHS of the tumor/surgery upper limb side (Δ = 2.64 kg; P < 0.001) and contralateral limb (Δ = 2.22 kg; P < 0.001), and on the 30-s CST score (Δ = 3.56repetitions; P < 0.001), favoring the Exercise group. No differences were observed on QLQ-BR23 domains.

CONCLUSIONS

Exercise training was an effective complementary therapy to prevent the deterioration of HRQoL and functional capacity during chemotherapy in women with early-stage BC.

摘要

目的

探讨监督性运动训练计划(SETP)对接受化疗的乳腺癌(BC)女性患者健康相关生活质量(HRQoL)和功能能力的有效性。

方法

93例早期BC女性患者被随机分为SETP加常规护理组(运动组,n = 47)或单纯常规护理组(UC组,n = 46)。SETP包括每周三次,将有氧运动和抗阻训练相结合,在化疗期间同时进行。使用欧洲癌症研究与治疗组织生活质量核心问卷30(QLQ-C30)和BC特异性模块(QLQ-BR23)评估HRQoL。通过最大自主握力(MVHS)和30秒椅子坐立试验(30-s CST)分析功能能力。这些终点指标在基线(t0)、中期(t1;t0后8或12周)和化疗结束时(t2;t0后20周)进行评估。采用意向性分析方法评估与基线相比的平均变化。

结果

混合线性模型分析显示,运动组在t2时QLQ-C30的几个领域恶化程度较小,包括总体健康状况/生活质量(Δ = 9.39分;P = 0.034)、QLQ-C30总结评分(Δ = 8.08分;P < 0.001)、身体领域(Δ = 15.14分;P < 0.001)、角色领域(Δ = 21.81分;P < 0.001)、认知领域(Δ = 9.16分;P = 0.032)和社会功能领域(Δ = 11.67分;P = 0.038),与UC组相比。同样,与UC组相比,运动组的疲劳程度(Δ = -20.19分;P < 0.001)和食欲减退程度(Δ = -13.69分;P = 0.034)显著更低。在肿瘤/手术上肢侧的MVHS(Δ = 2.64 kg;P < 0.001)和对侧肢体的MVHS(Δ = 2.22 kg;P < 0.001)以及30-s CST评分(Δ = 3.56次重复;P < 0.001)方面观察到显著的组间差异,运动组更优。在QLQ-BR23领域未观察到差异。

结论

运动训练是一种有效的辅助治疗方法,可预防早期BC女性患者化疗期间HRQoL和功能能力的恶化。

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