Allison Kelly C, McCuen-Wurst Courtney, Raevsky Allie, Holmes Nathaniel, Goldbach Macy, Guerra Carmen E, Rendle Katharine A, Cadet Tamara J, Krouse Robert S, Tchou Julia
Department of Psychiatry Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.
Rena Rowan Breast Center Abramson Cancer Center Department of Surgery Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.
Obes Sci Pract. 2024 Dec 21;10(6):e70023. doi: 10.1002/osp4.70023. eCollection 2024 Dec.
Obesity is related to the recurrence of breast cancer. In-person groups or individual telephone counseling currently comprise the behavioral weight loss (BWL) programs tested for cancer survivors. Group support via telehealth may be convenient and provide support from fellow survivors, but feasibility, acceptability, and efficacy testing are needed.
A single-arm, 6-month BWL program was conducted for female breast cancer survivors with an ECOG performance 0 or 1, BMI > 25 kg/m, and > 6 months from completion of adjuvant chemotherapy and/or radiation treatment. Participants attended 22 video group sessions over 6 months, completing acceptability ratings, weight measurements, Patient Health Questionnaire (PHQ-9), City of Hope Breast Cancer Quality of Life Scale (QOL), and International Physical Activity Questionnaire. Changes in survey scores and weight (last-observation carried forward) and differences in outcomes by patients' race were computed with paired -tests, ANCOVAs and Chi-square tests.
Twenty-one (5 Black, 15 White, 1 Asian American; Mean (SD) = 60.7 (11.6) years; BMI 33.1 (5.9) kg/m) survivors enrolled with 90% retention and 81.3% of sessions attended. Acceptability ratings were high (all > 4 on a five-point scale). Mean (SD) weight loss was 5.9% (5.2%), with 60% losing ≥ 5% of baseline weight; White participants lost 7.5% and Black participants lost 1.9% ( = 0.04). Significant improvements were observed in mood (PHQ-9; = 0.01) and physical wellbeing QOL ( = 0.01). Physical activity did not change.
This telehealth group BWL program was feasible and acceptable for breast cancer survivors, yielding a clinically significant weight loss. Future studies should test this intervention in larger, more diverse samples.
ClinicalTrials.gov identifier: NCT04855552, posted April 22, 2021.
肥胖与乳腺癌复发有关。目前，针对癌症幸存者进行测试的行为减肥（BWL）项目包括面对面小组或个人电话咨询。通过远程医疗提供的小组支持可能很方便，并能提供其他幸存者的支持，但仍需要进行可行性、可接受性和疗效测试。
对东部肿瘤协作组（ECOG）体能状态为0或1、体重指数（BMI）>25kg/m²、辅助化疗和/或放疗结束后超过6个月的女性乳腺癌幸存者开展了一项为期6个月的单臂BWL项目。参与者在6个月内参加了22次视频小组会议，完成了可接受性评分、体重测量、患者健康问卷（PHQ-9）、希望之城乳腺癌生活质量量表（QOL）和国际体力活动问卷。采用配对检验、协方差分析和卡方检验计算调查分数和体重的变化（末次观察结转）以及患者种族在结局方面的差异。
21名幸存者（5名黑人、15名白人、1名亚裔美国人；平均（标准差）=60.7（11.6）岁；BMI 33.1（5.9）kg/m²）入组，保留率为90%，会议出席率为81.3%。可接受性评分很高（五分制评分均>4分）。平均（标准差）体重减轻5.9%（5.2%），60%的人体重减轻≥基线体重的5%；白人参与者体重减轻7.5%，黑人参与者体重减轻1.9%（P=0.04）。情绪（PHQ-9；P=0.01）和身体健康生活质量（P=0.01）有显著改善。体力活动没有变化。
该远程医疗小组BWL项目对乳腺癌幸存者来说是可行且可接受的，能实现具有临床意义的体重减轻。未来的研究应在更大、更多样化的样本中测试这种干预措施。
ClinicalTrials.gov标识符：NCT04855552，于2021年4月22日发布。
