Beyer Mailin, Bischoff Christian, Lässing Johannes, Gockel Ines, Falz Roberto
Department of Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30627, Hannover, Germany.
Institute of Sports Medicine & Prevention, University Leipzig, Leipzig, Germany.
J Cancer Res Clin Oncol. 2024 Dec 24;151(1):13. doi: 10.1007/s00432-024-06064-y.
The reduced cardiorespiratory fitness (CRF) and functional capacity following surgical procedures and during cancer treatments is a major risk factor for morbidity and mortality among patients with cancer. We aimed to assess the impact of endurance and combined resistance exercise interventions during the postoperative rehabilitation period for patients with colorectal, breast, and prostate cancer.
A systematic search was conducted in MEDLINE Pubmed, Web of Science, and Cochrane Library until October 2023 for randomized controlled trials that assessed exercise interventions (aerobic/endurance; resistance or combined training) on postoperative patients with cancer. The trials evaluated the change in oxygen uptake (VO), six-minute walking distance (6MWD), quality of life (QoL), and fatigue.
Twelve studies, including 1298 patients, were part of this systematic review, and ten studies were included in the meta-analysis. Postoperative exercise interventions led to improvements in CRF and functional capacity (VO: MD 1.46 ml/kg/min; 95%-CI 0.33, 2.58; p = 0.01; 6MWD: MD 63.47 m; 95%-CI 28.18, 98.76; p = 0.0004, respectively) as well as QoL (0.91; 95%-CI 0.06, 1.76; p = 0.04). The quality of evidence was moderate to low.
Postoperative exercise interventions could effectively improve CRF, functional capacity and QoL as shown in this meta-analysis. However, there is a lack of high-quality trials with a higher number of participants examining the effects of postoperative exercise in patients with colorectal, breast, and prostate cancer. There is an obvious need for long-term, cancer-specific exercise therapies and their evaluation in cancer care.
手术操作后及癌症治疗期间心肺适能（CRF）和功能能力下降是癌症患者发病和死亡的主要危险因素。我们旨在评估耐力训练和联合抗阻运动干预对结直肠癌、乳腺癌和前列腺癌患者术后康复期的影响。
截至2023年10月，在MEDLINE Pubmed、科学网和考克兰图书馆进行了系统检索，以查找评估运动干预（有氧运动/耐力训练；抗阻训练或联合训练）对癌症术后患者影响的随机对照试验。这些试验评估了摄氧量（VO）、六分钟步行距离（6MWD）、生活质量（QoL）和疲劳程度的变化。
12项研究（包括1298名患者）纳入了本系统评价，10项研究纳入了荟萃分析。术后运动干预使CRF和功能能力得到改善（VO：平均差1.46 ml/kg/min；95%置信区间0.33，2.58；p = 0.01；6MWD：平均差63.47 m；95%置信区间28.18，98.76；p = 0.0004），生活质量也得到改善（0.91；95%置信区间0.06，1.76；p = 0.04）。证据质量为中等至低等。
如本荟萃分析所示，术后运动干预可有效改善CRF、功能能力和生活质量。然而，缺乏高质量、样本量更大的试验来研究术后运动对结直肠癌、乳腺癌和前列腺癌患者的影响。显然需要长期的、针对癌症的运动疗法及其在癌症护理中的评估。
