Yang Mengzhe, Amatya Bhasker, Malik Sana, Song Krystal, Marcella Stefanie, Voutier Catherine, Khan Fary
Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, Victoria, Australia.
Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, Victoria, Australia; Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Rehabilitation, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia.
J Rehabil Med. 2025 Jan 24;57:jrm40021. doi: 10.2340/jrm.v57.40021.
To evaluate existing evidence from published systematic reviews for the effectiveness and safety of rehabilitation interventions in adult patients with colorectal cancer.
A comprehensive literature search was conducted using medical/health science databases up to October 2024. Bibliographies of pertinent articles, journals, and grey literature were searched. Three reviewers independently selected potential reviews, assessed methodological quality, and graded the quality of evidence for outcomes using validated tools.
Sixty systematic reviews (761 randomized controlled trials) evaluated 5 categories of rehabilitation interventions. Over half of the included reviews (n = 31) were of moderate-high quality. The findings suggest: moderate-quality evidence for exercise interventions for improving physical fitness and quality of life; high-quality evidence for nutritional interventions in reducing postoperative infections; high-quality evidence for multimodal prehabilitation for improved preoperative functional capacity; moderate-quality evidence for nutritional interventions for improving humoral immunity, reducing inflammation, and length of stay; moderate-quality evidence for acupuncture in improving gastrointestinal functional recovery; psychosocial interventions in improving short-term quality of life and mental health, and lifestyle interventions for improved quality of life.
Rehabilitation interventions yielded positive effects across multiple outcomes. However, high-quality evidence is still needed to determine the most effective rehabilitation approaches for patients with colorectal cancer.
评估已发表的系统评价中关于成年结直肠癌患者康复干预措施有效性和安全性的现有证据。
截至2024年10月，使用医学/健康科学数据库进行了全面的文献检索。检索了相关文章、期刊的参考文献以及灰色文献。三位评审员独立选择潜在的综述，评估方法学质量，并使用经过验证的工具对结局的证据质量进行分级。
60项系统评价（761项随机对照试验）评估了5类康复干预措施。超过一半的纳入综述（n = 31）为中高质量。研究结果表明：运动干预在改善体能和生活质量方面有中等质量的证据；营养干预在减少术后感染方面有高质量的证据；多模式术前康复在改善术前功能能力方面有高质量的证据；营养干预在改善体液免疫、减轻炎症和缩短住院时间方面有中等质量的证据；针灸在改善胃肠功能恢复方面有中等质量的证据；心理社会干预在改善短期生活质量和心理健康方面有中等质量的证据，生活方式干预在改善生活质量方面有中等质量的证据。
康复干预在多个结局方面产生了积极影响。然而，仍需要高质量的证据来确定结直肠癌患者最有效的康复方法。
