Filis Panagiotis, Markozannes Georgios, Chan Doris Sm, Mauri Davide, Foukakis Theodoros, Matikas Alexios, Droufakou Stavroula, Pentheroudakis George, Tsilidis Konstantinos
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece; Department of Medical Oncology, University of Ioannina, Ioannina 45110, Greece.
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W12 0BZ, UK.
Crit Rev Oncol Hematol. 2025 Mar;207:104602. doi: 10.1016/j.critrevonc.2024.104602. Epub 2024 Dec 25.
To contribute to the refinement of future physical activity (PA) guidelines, which have remained mostly generic until now, we performed an umbrella review of meta-analyses for PA in cancer survivors.
Medline and Scopus databases were searched in January 2024 for systematic reviews and meta-analyses on the association/effect of any type of PA in every cancer type and for any studied outcome. Statistically significant meta-analyses were categorized into four evidence groups (strong, highly suggestive, suggestive, weak) using pre-established grading criteria.
A total of 102 publications reporting 740 meta-analytic associations were identified, including breast (n = 427), prostate (n = 104), hematological (n = 58), colorectal (n = 79) and lung (n = 54) cancer survivors. Overall, 401 (54 %) associations were nominally statistically significant, of which 16 were categorised as strong, 10 as highly suggestive, and 93 as suggestive evidence. In breast cancer, there was strong or highly suggestive evidence that post-diagnosis PA is associated with lower all-cause mortality, recurrence, cancer-related fatigue, depression, and higher mental health, body strength, aerobic capacity, and weight loss. In prostate cancer, strong evidence was identified for the positive association of PA with cardiovascular fitness, quality of life and fatigue amelioration. In colorectal cancer, strong and highly suggestive evidence supported the association of PA with lower all-cause mortality. In lung cancer, strong evidence supported the association of preoperative combination of breathing exercise and PA with reduced length of hospital stay.
This grading of the entirety of the available evidence can facilitate robust introduction of targeted exercise prescription in oncology care as standard practice.
为助力完善目前大多仍较为通用的未来体力活动（PA）指南，我们对癌症幸存者体力活动的荟萃分析进行了一项伞状综述。
2024年1月检索了Medline和Scopus数据库，以查找关于各类癌症中任何类型体力活动的关联/效应以及任何研究结局的系统评价和荟萃分析。使用预先确定的分级标准，将具有统计学意义的荟萃分析分为四个证据组（强、高度提示、提示、弱）。
共识别出102篇报告740个荟萃分析关联的出版物，包括乳腺癌（n = 427）、前列腺癌（n = 104）、血液系统癌症（n = 58）、结直肠癌（n = 79）和肺癌（n = 54）幸存者。总体而言，401个（54%）关联名义上具有统计学意义，其中16个被归类为强证据，10个为高度提示证据，93个为提示证据。在乳腺癌中，有强或高度提示证据表明诊断后体力活动与较低的全因死亡率、复发率、癌症相关疲劳、抑郁以及较高的心理健康、身体力量、有氧能力和体重减轻相关。在前列腺癌中，有强证据表明体力活动与心血管健康、生活质量改善和疲劳缓解呈正相关。在结直肠癌中，强和高度提示证据支持体力活动与较低全因死亡率的关联。在肺癌中，强证据支持术前呼吸锻炼与体力活动相结合与缩短住院时间相关。
对所有现有证据的这种分级有助于在肿瘤护理中作为标准实践有力地引入有针对性的运动处方。
