An Ki-Yong, Jeon Justin Y, Arthuso Fernanda Z, Wang Qinggang, Friedenreich Christine M, Courneya Kerry S
Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
Br J Cancer. 2025 Jul 23. doi: 10.1038/s41416-025-03123-0.
The effects of exercise on cancer outcomes may differ depending on its positioning within different cancer treatment combinations. We examined whether the associations between physical activity (PA) and cancer outcomes varied by cancer treatment modality or timing of PA.
We conducted a secondary analysis of the Prostate Cancer Cohort Study consisting of 830 men in Alberta, Canada with newly diagnosed prostate cancer. Lifetime prediagnosis PA was assessed by an in-person interview shortly after diagnosis whereas postdiagnosis PA was assessed at 2-3 year intervals by an in-person interview (first follow-up) or self-report (second and third follow-ups). Cox proportional hazards regression models were used to test interactions between PA and treatment modalities for disease-free survival, overall survival, and prostate cancer-specific disease-free survival.
Postdiagnosis vigorous PA significantly interacted with surgery (p < 0.001) and radiotherapy (p = 0.003). Specifically, patients who had surgery experienced a 61% lower likelihood of a disease-free survival event if they engaged in any versus no postdiagnosis vigorous PA (HR = 0.39, 95% CI = 0.27-0.57). Conversely, patients who received radiotherapy did not experience any benefit from postdiagnosis vigorous PA (HR = 1.14, 95% CI = 0.88-1.47).
The role of PA as a treatment for prostate cancer may depend on its combination and sequencing with other treatments.
运动对癌症预后的影响可能因其在不同癌症治疗组合中的位置而异。我们研究了体力活动（PA）与癌症预后之间的关联是否因癌症治疗方式或PA的时间不同而有所变化。
我们对前列腺癌队列研究进行了二次分析，该研究由加拿大艾伯塔省830名新诊断为前列腺癌的男性组成。诊断前的终生PA通过诊断后不久的面对面访谈进行评估，而诊断后的PA通过面对面访谈（首次随访）或自我报告（第二次和第三次随访）每2 - 3年进行评估。使用Cox比例风险回归模型来测试PA与治疗方式之间在无病生存期、总生存期和前列腺癌特异性无病生存期方面的相互作用。
诊断后剧烈PA与手术（p < 0.001）和放疗（p = 0.003）有显著的相互作用。具体而言，接受手术的患者如果在诊断后进行剧烈PA与不进行剧烈PA相比，无病生存事件的可能性降低61%（HR = 0.39，95% CI = 0.27 - 0.57）。相反，接受放疗的患者未从诊断后剧烈PA中获得任何益处（HR = 1.14，95% CI = 0.88 - 1.47）。
PA作为前列腺癌治疗方法的作用可能取决于其与其他治疗的组合和顺序。
