Eight-year follow-up of patient-reported outcomes in patients with breast cancer participating in exercise studies during chemotherapy.

IF 3.1 2区医学 Q2 ONCOLOGY Journal of Cancer Survivorship Pub Date : 2024-08-05 DOI:10.1007/s11764-024-01640-0

David Binyam, Willeke R Naaktgeboren, Wim G Groen, Neil K Aaronson, Anouk E Hiensch, Wim H van Harten, Martijn M Stuiver, Anne M May

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Abstract

Purpose: Numerous randomized controlled trials (RCTs) have shown beneficial exercise effects on fatigue, anxiety and depression and health-related quality of life (HRQoL) in breast cancer (BC) patients during and shortly after treatment. Here, we investigated the long-term effects of exercise during chemotherapy for BC on these outcomes.

Methods: We invited participants of two highly comparable RCTs that investigated the effects of exercise (EX) (versus usual care (UC)) during chemotherapy in patients with non-metastatic BC (N = 357) to participate in an 8-year follow-up. In both trials, fatigue, anxiety and depression and HRQoL were assessed using the same questionnaires, at multiple timepoints. Linear mixed-effect models were used to compare study arms over time.

Results: In total, 156 participants (EX = 82; UC = 74) completed the follow-up questionnaires. EX reported comparable general (between-group difference 0.73, 95% confidence interval (- 0.35; 1.80), ES = 0.18) and physical fatigue (0.55 (- 0.55; 1.65), ES = 0.13), small but statistically significantly higher levels of anxiety (1.24 (0.47 to 2.00), ES = 0.39) and depression (1.10 (0.34; 1.85), ES = 0.38), significantly lower global HRQoL (- 5.99 (- 10.65; - 1.32), ES = 0.34) and comparable summary HRQoL (- 1.90 (- 4.70; 0.89), ES = 0.16) compared to UC.

Conclusion: No long-term beneficial effects of exercise during chemotherapy on BC patients' fatigue, anxiety, depression or HRQoL were observed. The less favourable outcomes for mood and HRQoL that were observed 8 years after participation in an exercise intervention may be explained by selective loss-to-follow-up.

Implications for cancer survivors: The results highlight the need to incorporate strategies that promote physical activity maintenance after participation in an exercise programme to also counteract long-term detrimental side effects of cancer treatment.

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对化疗期间参加运动研究的乳腺癌患者的患者报告结果进行八年随访。

目的：大量随机对照试验（RCT）显示，运动对乳腺癌（BC）患者在治疗期间和治疗后不久的疲劳、焦虑和抑郁以及与健康相关的生活质量（HRQoL）都有益处。在此，我们研究了乳腺癌化疗期间运动对这些结果的长期影响：我们邀请了两项具有高度可比性的 RCT 参与者（N = 357）参加为期 8 年的随访，这两项 RCT 研究了非转移性 BC 患者化疗期间运动（EX）（与常规护理（UC））的效果。在这两项试验中，均使用相同的问卷在多个时间点对疲劳、焦虑和抑郁以及 HRQoL 进行了评估。采用线性混合效应模型对不同时间段的研究臂进行比较：共有 156 名参与者（EX = 82；UC = 74）完成了随访问卷。EX组报告的一般情况（组间差异为0.73，95%置信区间（- 0.35; 1.80），ES = 0.18）和身体疲劳（0.55 (- 0.55; 1.65)，ES = 0.13）与UC组相当，焦虑水平略高，但在统计学上显著高于UC组（1.24 (0. 47 to 2.00)，ES = 0.13）。47 to 2.00），ES = 0.39）和抑郁（1.10 (0.34; 1.85)，ES = 0.38），总体 HRQoL（- 5.99 (- 10.65; - 1.32)，ES = 0.34）明显低于 UC，而摘要 HRQoL（- 1.90 (- 4.70; 0.89)，ES = 0.16）与 UC 相当：结论：化疗期间的运动对 BC 患者的疲劳、焦虑、抑郁或 HRQoL 均无长期有益影响。在参与运动干预8年后观察到的情绪和HRQoL方面的较差结果，可能是由于选择性随访损失造成的：研究结果强调，有必要在参与运动计划后采取促进体育锻炼的策略，以消除癌症治疗带来的长期有害副作用。

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来源期刊

Journal of Cancer Survivorship ONCOLOGY-

CiteScore

7.00

自引率

10.80%

发文量

149

审稿时长

>12 weeks

期刊介绍： Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.