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YOCAS©® 瑜伽对老年(≥60 岁)与年轻(≤59 岁)癌症幸存者癌症相关疲劳和生活质量的影响:一项全国性、多中心、3 期随机对照试验的二次分析。

The effect of YOCAS©® yoga on cancer-related fatigue and quality of life in older (60+) vs. younger (≤ 59) cancer survivors: Secondary analysis of a nationwide, multicenter, phase 3 randomized controlled trial.

机构信息

Rutgers Cancer Institute of NJ, Rutgers University, New Brunswick, NJ 08901, United States of America.

James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America; Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America.

出版信息

J Geriatr Oncol. 2024 Nov;15(8):102076. doi: 10.1016/j.jgo.2024.102076. Epub 2024 Oct 4.

Abstract

INTRODUCTION

Older cancer survivors consistently express the need for interventions to reduce cancer-related fatigue (CRF) and maintain quality of life (QOL). Yoga is a promising treatment to address CRF and QOL. However, research comparing the efficacy of yoga for improving fatigue and QOL in older survivors (60+) vs. younger adult survivors (≤59)is limited. Our objective was to examine the effects of yoga on CRF and QOL in older survivors vs. younger survivors.

MATERIALS AND METHODS

We conducted a secondary analysis of a nationwide, multicenter, phase 3 randomized controlled trial. For this study, participants who provided evaluable pre- and post-intervention data on the Functional Assessment for Chronic Illness Therapy-Fatigue (FACIT-F) and the Functional Assessment for Cancer Therapy-General (FACT-G) were eligible. The yoga intervention comprises gentle Hatha and Restorative Yoga and includes breathing exercises, physical alignment postures, and mindfulness.

RESULTS

Of the 177 participants included in the study, 30.1 % were aged 60+ and 69.9 % were aged ≤59. More younger participants had breast cancer (82.0 % vs. 59.2 %. p = 0.009), surgery (98.9 % vs. 77.8 %, p < 0.001), and chemotherapy (80.5 % vs. 55.6 %, p = 0.001). There were no differences in the cancer stage (66.1 % stage I or II). There were statistically significant and clinically meaningful within-group improvements from baseline to post-intervention in CRF for participants aged ≤59 and participants aged 60+ (4.0 ± 0.7, p < 0.001 vs. 3.1 ± 1.0, p = 0.003). Both age groups also demonstrated improvements in QOL (3.2 ± 0.8, p < 0.001 vs. 2.1 ± 1.2, p = 0.078), physical (1.6 ± 0.3, p < 0.001 vs. 0.8 ± 0.5, p = 0.084), functional (0.7 ± 0.3, p = 0.048 vs. 1.0 ± 0.5, p = 0.037), and emotional well-being. There were no significant between-group differences between the age groups. Most younger and older participants reported that yoga helped improve their sleep quality (92.8 % vs 88.5 %) and they would recommend it to other survivors (98.2 % vs 90.4 %).

DISCUSSION

Older cancer survivors who undergo gentle Hatha and restorative yoga performed two to three times per week for four weeks at a low to moderate level of intensity have similar improvements in CRF and QOL compared to participants aged ≤59. For older survivors experiencing these toxicities, it is reasonable for clinicians to prescribe yoga.

CLINICALTRIALS

govidentifier: NCT00397930.

摘要

简介

老年癌症幸存者一直表达需要干预措施来减轻与癌症相关的疲劳 (CRF) 并维持生活质量 (QOL)。瑜伽是一种有前途的治疗方法,可以解决 CRF 和 QOL 问题。然而,比较瑜伽对改善老年幸存者(60+)和年轻成年幸存者(≤59)疲劳和 QOL 的疗效的研究有限。我们的目的是研究瑜伽对老年幸存者和年轻幸存者的 CRF 和 QOL 的影响。

材料和方法

我们对一项全国性、多中心、3 期随机对照试验进行了二次分析。对于这项研究,符合以下条件的参与者提供了有评估价值的预干预和干预后功能评估慢性疾病治疗疲劳量表(FACIT-F)和癌症治疗功能评估一般量表(FACT-G)数据。瑜伽干预包括温和的哈他瑜伽和恢复性瑜伽,包括呼吸练习、身体姿势排列和正念。

结果

在纳入研究的 177 名参与者中,30.1%的年龄在 60 岁以上,69.9%的年龄在 59 岁以下。更多的年轻参与者患有乳腺癌(82.0%对 59.2%,p=0.009)、手术(98.9%对 77.8%,p<0.001)和化疗(80.5%对 55.6%,p=0.001)。癌症分期没有差异(66.1%为 I 期或 II 期)。≤59 岁和 60 岁以上的参与者从基线到干预后,CRF 均有统计学意义和临床意义的组内改善(4.0±0.7,p<0.001 对 3.1±1.0,p=0.003)。两个年龄组的 QOL 也都有所改善(3.2±0.8,p<0.001 对 2.1±1.2,p=0.078),身体(1.6±0.3,p<0.001 对 0.8±0.5,p=0.084),功能(0.7±0.3,p=0.048 对 1.0±0.5,p=0.037)和情绪健康。两个年龄组之间没有显著的组间差异。大多数年轻和老年参与者报告瑜伽有助于改善他们的睡眠质量(92.8%对 88.5%),他们会向其他幸存者推荐(98.2%对 90.4%)。

讨论

每周进行两到三次、每次 4 周、强度为低到中等的温和哈他瑜伽和恢复性瑜伽的老年癌症幸存者与≤59 岁的参与者相比,在 CRF 和 QOL 方面有相似的改善。对于经历这些毒性的老年幸存者,临床医生开瑜伽处方是合理的。

临床试验

govidentifier:NCT00397930。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba9c/11822854/7ba3a90f5659/nihms-2050733-f0001.jpg

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