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P-move:一项针对接受一线化疗后晚期胰腺或胆道癌(aPBC)患者进行运动的随机对照试验。

P-move: a randomized control trial of exercise in patients with advanced pancreatic or biliary tract cancer (aPBC) receiving beyond first-line chemotherapy.

机构信息

Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany.

West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

出版信息

Support Care Cancer. 2024 Jun 15;32(7):437. doi: 10.1007/s00520-024-08650-9.

Abstract

PURPOSE

Patients with advanced pancreatic and biliary tract cancer (aPBC) frequently suffer from high symptom burden. Exercise can reduce treatment side effects and improve patient-related outcomes (PROMs). However, evidence from prospective studies regarding feasibility and efficacy in advanced settings are sparse. The primary aim of this prospective, randomized-controlled study was to evaluate the feasibility and effects of exercise (ET) in patients with aPBC.

METHODS

Patients with aPBC beyond first-line therapy were randomized according to the minimization procedure with stratification by gender, age, and loss of body weight in the past six months. The intervention group (IG) completed 3 training units/week for 8 weeks (1x supervised strength sessions, 2x individualized home-based sessions). Control group (CG) received recommendations on physical activity during cancer.

RESULTS

41 patients (stage IV pancreatic or biliary tract cancer) were included no adverse events related to exercise occurred during the trial. Physical function increased significantly in IG in 5 out of 7 physical domains. Comparison of IG and CG at 8 weeks (t2) showed significant differences in favour of IG in leg press (p=0.001), bench press (p=0.011), sit-to-stand (p=0.001) and crunch (0.006). Constipation revealed a significant difference in favour of IG at t2 (p=0.033). Quality of life stabilized/increased in IG during the study period compared to a decrease in CG. Throughout/Over the 8 weeks, fatigue notably reduced in the IG (p=0.028).

CONCLUSION

Exercise is safe and feasible in patients with aPBC undergoing further line therapy. Significant improvements in physical functioning and increased quality of life were achieved. German Clinical Trials Register ID: DRKS00021179; Registration date 15.05.2020.

摘要

目的

晚期胰腺和胆道癌(aPBC)患者常遭受高症状负担。运动可以减少治疗副作用并改善患者相关结局(PROMs)。然而,前瞻性研究中关于在晚期环境中可行性和疗效的证据很少。本前瞻性、随机对照研究的主要目的是评估运动(ET)在 aPBC 患者中的可行性和效果。

方法

根据最小化程序,对一线治疗后进展的 aPBC 患者进行随机分组,并按性别、年龄和过去六个月体重减轻进行分层。干预组(IG)每周完成 3 次训练单元/周,共 8 周(1 次监督力量训练,2 次个体化家庭训练)。对照组(CG)在癌症期间接受身体活动建议。

结果

41 名患者(IV 期胰腺或胆道癌)入组,试验期间无与运动相关的不良事件。IG 在 7 个身体领域中的 5 个领域的身体功能显著增加。在 8 周时(t2)比较 IG 和 CG,IG 在腿部按压(p=0.001)、卧推(p=0.011)、从坐姿到站姿(p=0.001)和仰卧起坐(p=0.006)方面具有显著优势。IG 在 t2 时便秘有显著优势(p=0.033)。与 CG 相比,IG 在研究期间的生活质量稳定/增加。在整个 8 周期间,IG 的疲劳明显减轻(p=0.028)。

结论

在接受进一步治疗的 aPBC 患者中,运动是安全可行的。身体功能显著改善,生活质量提高。德国临床试验注册处编号:DRKS00021179;注册日期 2020 年 5 月 15 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efa/11180022/25fa68238a48/520_2024_8650_Fig1_HTML.jpg

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