Chalmers Oliver, Waddell Alex, Choudhury Ananya, Sale Craig, Harwood Amy E
Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK.
Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK.
BMJ Oncol. 2025 Jul 10;4(1):e000615. doi: 10.1136/bmjonc-2024-000615. eCollection 2025.
The aim of this work was to review the literature on the mechanisms by which lifestyle interventions attenuate radiation therapy-induced side effects. A scoping review based on the Joanna Briggs Institute methodological framework was undertaken. MEDLINE, CINAHL and CENTRAL were searched up until 13 March 2024. Studies assessing the potential mechanistic effects of lifestyle interventions on outcomes in adult (>18 years of age) cancer patients undergoing radiotherapy, including any cancer type or intervention timing (before, during, after radiotherapy), were included. Data were extracted regarding study design, intervention characteristics and included outcome measures. Nine studies were included in the review. Study populations included patients with a range of cancers, including head and neck, prostate, breast, lung, lower gastrointestinal, rectal, pelvic and leukaemia. Lifestyle interventions consisted primarily of nutritional supplements, diets or traditional Chinese medicinal ingredients. Exercise programmes were also included. Those that were available involved either resistance training alone or in combination with aerobic exercise. The most common side effects included site-specific toxicity, with some interventions noting improvements to symptoms, alongside alterations to inflammatory cytokine and lymphocyte concentrations. Radiation-induced weight loss and frailty were noted, which may be prevented with interventions that target skeletal muscle metabolism. With more research to fully elucidate the potential mechanisms and consistent evidence of efficacy, lifestyle interventions may present promising non-pharmacological therapeutic options to alleviate some of the side effects of radiotherapy.
这项工作的目的是回顾关于生活方式干预减轻放疗引起的副作用的机制的文献。基于乔安娜·布里格斯研究所方法框架进行了一项范围综述。检索了截至2024年3月13日的MEDLINE、CINAHL和CENTRAL数据库。纳入评估生活方式干预对接受放疗的成年（>18岁）癌症患者结局的潜在机制影响的研究，包括任何癌症类型或干预时间（放疗前、放疗期间、放疗后）。提取了关于研究设计、干预特征和纳入的结局指标的数据。该综述纳入了9项研究。研究人群包括患有一系列癌症的患者，包括头颈癌、前列腺癌、乳腺癌、肺癌、下消化道癌、直肠癌、盆腔癌和白血病。生活方式干预主要包括营养补充剂、饮食或中药成分。还包括运动计划。现有的运动计划包括单独的阻力训练或与有氧运动相结合。最常见的副作用包括特定部位的毒性，一些干预措施指出症状有所改善，同时炎症细胞因子和淋巴细胞浓度也有所改变。注意到放疗引起的体重减轻和身体虚弱，针对骨骼肌代谢的干预措施可能预防这些情况。随着更多研究充分阐明潜在机制并获得一致的疗效证据，生活方式干预可能为减轻放疗的一些副作用提供有前景的非药物治疗选择。
