Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Integr Cancer Ther. 2024 Jan-Dec;23:15347354241291176. doi: 10.1177/15347354241291176.
Physical activity, as a promising complementary therapy, has shown considerable potential for reducing chemotherapy-related cardiotoxicity (CTRCT) and enhancing cardiorespiratory function (CRF). This study aimed to systematically assess the effects of physical activity on CTRCT and CRF in various cancer survivors receiving chemotherapy. A systematic review and meta-analysis was conducted. A literature search was conducted across 8 databases from inception to January 2024 and was limited to the English and Chinese languages. Statistical analysis was conducted using RevMan 5.3 and Stata 17.0 software. Sixteen randomized controlled trials (RCTs) were included in the systematic review and 15 RCTs were included in the meta-analysis. Among various cancer survivors undergoing chemotherapy, physical activity markedly increased absolute oxygen uptake (VO2peak or VO2max; WMD = 292.99, 95% confidence interval [CI]:87.87 to 498.12, = .005), with significant effects of subgroup analysis at 4 to 10 weeks ( = .02) or over 16 weeks ( < .01), moderate-to-high or high intensity training (both < .0001), patients with breast cancer ( = .009) and reported CTRCT ( = .007); relative VO2peak or VO2max(WMD = 3.30, 95%CI: 2.02 to 4.58, < .00001), with significant effects of subgroup analysis at 10 to 16 weeks or over 16 weeks, moderate-to-high or high intensity training, patients with breast cancer, with or without reported CTRCT and exercise during chemotherapy (all < .01); E/A values (WMD = 0.11, 95%CI:0.03 to 0.18, = .007) and flow-mediated dilatation (WMD = 2.71, 95%CI:1.49 to 3.94, < .0001). Compared to the control group, physical activity had no significant improvement in E/e' values ( = .50), NT-proBNP ( = .12), hs-cTn ( = 3.83), left ventricular ejection fraction (WMD = 2.89, 95%CI: -3.28 to 9.06, = .36) with non-significant effects being independent of exercise intensity or duration, with or without CTRCT and cancer types (all > .05), and global longitudinal strain (WMD = 0.37, 95%CI: -0.20 to 0.94, = .20) with non-significant effects being independent of exercise duration and cancer types(both > .05). Physical activity may be an effective complementary therapy to improve CRF and CTRCT in various cancer survivors, particularly during medium to long duration and moderate-to-high and high intensity exercise with concurrent chemotherapy.
身体活动作为一种有前途的补充疗法，已显示出在降低化疗相关性心脏毒性（CTRCT）和增强心肺功能（CRF）方面具有相当大的潜力。本研究旨在系统评估身体活动对接受化疗的各种癌症幸存者的 CTRCT 和 CRF 的影响。进行了系统评价和荟萃分析。从开始到 2024 年 1 月，在 8 个数据库中进行了文献检索，仅限于英文和中文。使用 RevMan 5.3 和 Stata 17.0 软件进行统计分析。系统评价纳入了 16 项随机对照试验（RCT），荟萃分析纳入了 15 项 RCT。在接受化疗的各种癌症幸存者中，身体活动显著增加了绝对摄氧量（VO2peak 或 VO2max；WMD=292.99，95%置信区间[CI]：87.87 至 498.12， = .005），亚组分析在 4 至 10 周（ = .02）或 16 周以上（ < .01）、中等至高强度训练（均 < .0001）、乳腺癌患者（ = .009）和报告的 CTRCT（ = .007）具有显著效果；相对 VO2peak 或 VO2max（WMD=3.30，95%CI：2.02 至 4.58， < .00001），亚组分析在 10 至 16 周或 16 周以上、中等至高强度训练、乳腺癌患者、有或无报告的 CTRCT 和化疗期间运动时具有显著效果（均 < .01）；E/A 值（WMD=0.11，95%CI：0.03 至 0.18， = .007）和血流介导的扩张（WMD=2.71，95%CI：1.49 至 3.94， < .0001）。与对照组相比，身体活动对 E/e' 值（ = .50）、NT-proBNP（ = .12）、hs-cTn（ = 3.83）、左心室射血分数（WMD=2.89，95%CI：-3.28 至 9.06， = .36）无显著改善，与运动强度或时间无关，与有无 CTRCT 和癌症类型无关（均 > .05），整体纵向应变（WMD=0.37，95%CI：-0.20 至 0.94， = .20）与运动时间和癌症类型无关（均 > .05），运动强度无显著影响。身体活动可能是一种有效的补充疗法，可改善各种癌症幸存者的 CRF 和 CTRCT，特别是在中等至长持续时间和中等至高强度运动与同时化疗期间。
