Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
Department of Physical Therapy, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Support Care Cancer. 2024 Jun 4;32(7):406. doi: 10.1007/s00520-024-08606-z.
The efficacy of exercise in men with prostate cancer (PCa) on active surveillance (AS) remains unclear. In this meta-analysis, we aimed to examine the effects of exercise in PCa patients on AS.
A literature search was conducted in PubMed, EMBASE, and the Cochrane Library using search terms, including exercise, PCa, AS, and randomized controlled trials (RCTs). The means and standard deviations for peak oxygen consumption (VO), prostate-specific antigen (PSA) levels, and quality of life (QoL) were extracted for the intervention and control groups. A random-effects model was used to summarize the effects of exercise.
Of the 158 identified studies, six RCTs with 332 patients were included. The interventions included lifestyle modifications (aerobic exercise + diet) in three studies and different exercise modalities in three studies. The intervention duration was 2-12 months; three interventions were supervised and three were self-directed. The pooled weighted mean difference between exercise and usual care for VO was 1.42 mL/kg/min (95% confidence interval [CI]: 0.30 to 2.54, P ≤ 0.001). A non-significant effect was observed for QoL (pooled standardized mean difference [SMD]: 0.24, 95% CI: - 0.03 to 0.51, P = 0.08) which became statistically significant and stronger after excluding one outlier study (P < 0.001). Exercise also had a positive effect on PSA levels (pooled SMD: - 0.43, 95% CI: - 0.87 to 0.01, P = 0.05).
Exercise improves cardiorespiratory fitness and may improve QoL and PSA levels in men with PCa on AS. Further studies with larger sample sizes are warranted to obtain more reliable results.
运动对于接受主动监测（AS）的前列腺癌（PCa）患者的疗效尚不清楚。本研究旨在评估运动对 AS 患者的影响。
通过检索 PubMed、EMBASE 和 Cochrane Library 中的文献，使用包括“exercise”“PCa”“AS”和“randomized controlled trials”等在内的检索词进行文献检索。提取干预组和对照组的峰值摄氧量（VO）、前列腺特异性抗原（PSA）水平和生活质量（QoL）的均值和标准差。使用随机效应模型对运动的效果进行汇总。
在纳入的 158 项研究中，有 6 项 RCT 纳入了 332 例患者。干预措施包括 3 项研究中的生活方式改变（有氧运动+饮食）和 3 项研究中的不同运动方式。干预时间为 2-12 个月；3 项干预措施为监督，3 项为自我指导。与常规护理相比，运动对 VO 的加权均数差为 1.42 mL/kg/min（95%置信区间：0.30-2.54，P≤0.001）。QoL 的效果不显著（合并标准化均数差：0.24，95%置信区间：-0.03-0.51，P=0.08），但排除一个异常值研究后，效果变得显著且更强（P<0.001）。运动对 PSA 水平也有积极影响（合并标准化均数差：-0.43，95%置信区间：-0.87-0.01，P=0.05）。
运动可改善心肺功能，可能改善接受 AS 的 PCa 患者的 QoL 和 PSA 水平。需要进一步开展样本量更大的研究，以获得更可靠的结果。
