D'Silva Cherishma, Shetty Vijith, Fernandes Donald, Jean-Pierre Baeyen, Kumari N Suchetha, Srivastava Saumya, Rajan Samuel Stephen
Father Muller College of Physiotherapy, Mangalore, India.
Department of Medical Oncology, KS Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, India.
Asian Pac J Cancer Prev. 2025 May 1;26(5):1653-1660. doi: 10.31557/APJCP.2025.26.5.1653.
Sarcopenia is considered an independent prognostic factor for overall survival and performance status in head and neck cancer (HNC) receiving chemo-radiotherapy (CRT). CRT is known to cause sleep disturbances, increased pain perception, depression leading to reduced quality of life (QOL). Exercise-based rehabilitation has emerged as a promising strategy for improving outcomes in HNC. Our study aimed to evaluate effect of exercise on sarcopenia and QOL in patients with HNC receiving CRT.
Seventy HNC patients, aged 40-70 years TNM stage III- IVb receiving CRT, were randomized into two groups and received intervention for seven weeks. Intervention Group, IG (n=40) received combined aerobic and resistance training according to the ACSM guidelines. Control Group, CG (n=40) were advised to walk according to the NCCN guidelines. Sarcopenia was assessed using Bio Impedance Analyser (BIA), muscle strength using JAMAR hand dynamometer and QOL by FACT H&N on pre CRT day 1 and post 7 weeks. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess within-group differences and between-group comparisons respectively.
80 participants with a mean age of 58.44 ±3.75 years were included. IG showed a smaller decrease in total skeletal muscle mass compared to CG with IGs total skeletal muscle mass decreasing from 35 to 30 and CGs muscle mass decreasing from 40 to 21 (p<0.001). QOL showed significant improvement in CG from 66 to 61 (p < 0.001). In contrast, IGs quality of life saw a minor, non-significant change from 62 to 61.
Sarcopenia was lesser in IG compared to CG, highlighting the favourable impact of resistance training and its inclusion in the HNC rehabilitation. However, CG demonstrated significant improvements in quality of life as compared to IG suggesting that quality of life is a multifaceted construct that may not be directly correlated with physical improvements alone.
肌肉减少症被认为是接受放化疗（CRT）的头颈癌（HNC）患者总生存期和身体机能状态的独立预后因素。已知CRT会导致睡眠障碍、疼痛感知增加、抑郁，进而导致生活质量（QOL）下降。基于运动的康复已成为改善HNC患者预后的一种有前景的策略。我们的研究旨在评估运动对接受CRT的HNC患者肌肉减少症和生活质量的影响。
70例年龄在40 - 70岁、TNM分期为III - IVb期且接受CRT的HNC患者被随机分为两组，并接受为期7周的干预。干预组（IG，n = 40）根据美国运动医学学会（ACSM）指南接受有氧训练和抗阻训练相结合的方案。对照组（CG，n = 40）被建议按照美国国立综合癌症网络（NCCN）指南进行散步。在放化疗前第1天和7周后，使用生物电阻抗分析仪（BIA）评估肌肉减少症，使用JAMAR握力计评估肌肉力量，并通过头颈癌功能评估量表（FACT H&N）评估生活质量。分别使用Wilcoxon符号秩检验和Mann - Whitney U检验来评估组内差异和组间比较。
纳入了80名平均年龄为58.44±3.75岁的参与者。与CG相比，IG的总骨骼肌质量下降幅度较小，IG的总骨骼肌质量从35下降到30，而CG的肌肉质量从40下降到21（p < 0.001）。CG的生活质量从66显著提高到61（p < 0.001）。相比之下，IG的生活质量从62到61有轻微的、不显著的变化。
与CG相比，IG的肌肉减少症较轻，这突出了抗阻训练的有利影响及其在HNC康复中的应用。然而，与IG相比，CG的生活质量有显著改善，这表明生活质量是一个多方面的概念，可能不仅仅与身体状况的改善直接相关。
