Institute for Sport and Sport Science, Division of Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany.
Immanuel Hospital Märkische Schweiz, AND Medical University of Brandenburg Theodor Fontane, BuckowRüdersdorf Bei Berlin, Germany.
BMC Med. 2024 Oct 8;22(1):442. doi: 10.1186/s12916-024-03671-x.
Increased levels of physical activity are associated with a reduction of breast cancer mortality, especially in postmenopausal women with positive hormone receptor status. So far, previous observational case-control and cohort studies have focused on associations between overall leisure time physical activity and survival of women with breast cancer in general.
In this multicenter prospective cohort study, conducted in Germany between 30th August 2012 to 29th December 2017, we investigated general physical activity in a homogenous sample of n = 1440 postmenopausal women with advanced (inoperable locally advanced or metastatic), hormone receptor-positive breast cancer receiving the same therapy (everolimus and exemestane). Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire (GLTEQ) before and every 3 months during treatment. Participants were then classified into "active" and "insufficiently active" to screen their activity behavior the week prior to medical treatment. In addition, changes in physical activity patterns were assessed. Adjusted Cox regression analyses were performed for the activity categories to determine hazard ratios (HR). Besides progression-free survival (PFS), adverse events (AEs), QoL, and fatigue were assessed every 3 months until study termination.
Compared to "insufficiently active" patients, "active" individuals indicated a significantly longer PFS (HR: 0.84 [0.74; 0.984], p = .0295). No significant differences were observed for changes of physical activity behavior. Patients who reported to be "active" at baseline revealed significantly fewer AEs compared to "insufficiently" active patients. In detail, both severe and non-severe AEs occurred less frequently in the "active" patients group. In line with that, QoL and fatigue were better in physical "active" patients compared to their insufficient active counterparts at the last post-baseline assessment. Participants who remained or become active indicated less AEs, a higher QoL, and reduced fatigue levels.
Physical activity behavior prior to medical treatment might have prognostic value in patients with advanced breast cancer in terms of extending the PFS. Moreover, physical activity before and during treatment may reduce treatment-related side effects and improve patients' QoL and fatigue.
EUPAS9462. Registered 30th October 2012 "retrospectively registered."
更高水平的身体活动与降低乳腺癌死亡率相关，尤其是在激素受体阳性的绝经后妇女中。到目前为止，之前的观察性病例对照和队列研究主要集中在整体休闲时间身体活动与一般乳腺癌患者生存之间的关系上。
本研究是一项在德国进行的多中心前瞻性队列研究，时间范围为 2012 年 8 月 30 日至 2017 年 12 月 29 日，我们调查了 n = 1440 名接受相同治疗（依维莫司和依西美坦）的晚期（局部晚期不可手术或转移性）、激素受体阳性乳腺癌绝经后妇女同质样本中的一般身体活动。使用 Godin 休闲时间运动问卷（GLTEQ）在治疗前和治疗期间每 3 个月评估一次自我报告的身体活动。参与者随后根据治疗前一周的活动行为被分为“活跃”和“不活跃”，以筛查其活动行为。此外，还评估了身体活动模式的变化。为了确定风险比（HR），对活动类别进行了调整后的 Cox 回归分析。除无进展生存期（PFS）、不良事件（AE）、生活质量（QoL）和疲劳外，还每 3 个月评估一次，直到研究结束。
与“不活跃”患者相比，“活跃”患者的 PFS 显著延长（HR：0.84 [0.74；0.984]，p = 0.0295）。未观察到身体活动行为变化的显著差异。基线时报告为“活跃”的患者与“不活跃”患者相比，AE 发生率显著降低。具体而言，严重和非严重 AE 在“活跃”患者组中发生频率较低。与此一致的是，与不活跃患者相比，身体活跃的患者在最后一次基线后评估时 QoL 和疲劳状况更好。保持或变得活跃的参与者表明，AE 更少，QoL 更高，疲劳水平降低。
在考虑到延长 PFS 的情况下，治疗前的身体活动行为可能对晚期乳腺癌患者具有预后价值。此外，治疗前和治疗期间的身体活动可能会减少与治疗相关的副作用，并改善患者的 QoL 和疲劳。
EUPAS9462。2012 年 10 月 30 日注册“回顾性注册”。
