The Nightingale and Prevent Breast Cancer Centre, Manchester University Hospital Foundation NHS Trust, Manchester, UK.
Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK.
Breast Cancer Res Treat. 2024 Aug;207(1):203-212. doi: 10.1007/s10549-024-07356-0. Epub 2024 May 17.
A combined body weight loss and upper body/arm exercise programme is a potential strategy for managing Breast cancer related lymphoedema (BCRL), but there is limited data on the best method for delivery or its potential efficacy.
Fifty-seven women with overweight/obesity and BCRL were randomised to a 12 week supervised (n = 12) or home-based combined weight loss and upper body/arm exercise programme (n = 16), a home-based upper-body arm exercise only programme (n = 17) or standard care (n = 12). Primary outcomes were uptake, retention and changes in weight and change in Relative Arm Volume Increase (RAVI) using analysis of covariance (ANCOVA).
Sixteen percent of women invited joined the study and 49 completed the trial (85% retention). Reductions in weight occurred in the supervised and home-based weight control and exercise programmes; Mean (95% CI) change compared to standard care - 1.68 (- 4.36 to - 1.00), - 2.47(- 4.99 to - 0.04) Kg. Reductions in perometer assessed RAVI were seen in the supervised and home-based combined weight control and arm exercise groups and the weight stable home-based arm exercise only group: mean (95% CI) change compared to standard care - 2.4 (- 5.0 to + 0.4),- 1.8 (- 4.3 to + 0.7), - 2.5(- 4.9 to - 0.05)%.
Women with BCRL and overweight and obesity engaged in diet and exercise weight loss programmes. Both weight loss/arm exercise programmes led to modest changes in weight and BCRL. Comparable reductions in BCRL were reported in the weight stable group undertaking arm exercise only. The independent and combined effects of weight loss and exercise on BCRL need further study.
ISRCTN86789850 https://doi.org/10.1186/ISRCTN86789850 , registered 2011.
体重减轻与上肢/臂锻炼相结合的方案可能是管理乳腺癌相关淋巴水肿（BCRL）的一种策略，但关于其最佳实施方法或潜在疗效的数据有限。
将 57 名超重/肥胖且患有 BCRL 的女性随机分配至 12 周的监督（n=12）或家庭为基础的联合减重和上肢/臂锻炼方案（n=16）、家庭为基础的仅上肢臂锻炼方案（n=17）或标准护理（n=12）。主要结局是采用协方差分析（ANCOVA）评估的参与度、保留率和体重变化以及相对臂容积增加（RAVI）的变化。
邀请的女性中有 16%参加了研究，49 名女性完成了试验（保留率为 85%）。监督和家庭体重控制与锻炼方案中体重均有所减轻；与标准护理相比，体重减轻的平均值（95%CI）分别为-1.68（-4.36 至-1.00）和-2.47（-4.99 至-0.04）kg。监督和家庭联合体重控制和手臂锻炼组以及体重稳定的家庭仅手臂锻炼组的周长评估 RAVI 均有降低：与标准护理相比，体重减轻的平均值（95%CI）分别为-2.4（-5.0 至 0.4）、-1.8（-4.3 至 0.7）和-2.5（-4.9 至-0.05）%。
患有 BCRL 和超重/肥胖的女性参与了饮食和运动减肥计划。体重减轻/手臂锻炼方案均导致体重和 BCRL 适度减轻。仅进行手臂锻炼的体重稳定组报告了类似的 BCRL 减轻。体重减轻和运动对 BCRL 的独立和联合影响需要进一步研究。
ISRCTN86789850（https://doi.org/10.1186/ISRCTN86789850），2011 年注册。
