直肠癌患者确诊时的体力活动与新辅助化放疗后肿瘤下移有关

IF 4.9 1区 医学 Q1 ONCOLOGY Radiotherapy and Oncology Pub Date : 2024-09-10 DOI:10.1016/j.radonc.2024.110523
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引用次数: 0

摘要

背景直肠癌患者通常接受新辅助化放疗,然后等待一段时间再进行手术切除。对新辅助化放疗的良好或完全反应可使器官得以保留,这就凸显了提高反应率的必要性。临床前研究表明,在新辅助化放疗期间进行体育锻炼可改善肿瘤缩小。目的 研究直肠癌患者在确诊时的体育锻炼和身体机能是否与新辅助化放疗后肿瘤缩小有关。材料和方法纳入参加荷兰前瞻性结肠直肠癌队列(荷兰前瞻性结肠直肠癌队列是一个为科学研究提供基础设施的全国性队列)并接受直肠癌新辅助化放疗的患者。肿瘤降期分为良好/完全降期或中度/差降期。体力活动(总体力活动、中强度体力活动(MVPA)和荷兰体力活动指南遵守情况)和身体机能通过问卷进行评估。在对相关混杂因素进行调整后,对体力活动和身体机能与肿瘤分期的关系进行了逻辑回归分析。中度(OR = 2.07; 95%CI = 1.07 - 4.07; p = 0.03)或高度(OR = 2.05; 95%CI = 1.05 - 4.07; p = 0.04)MVPA 水平的患者比低水平的患者更有可能获得良好/完全的肿瘤缩小。结论我们发现,与自我报告MVPA水平低的直肠癌患者相比,在新辅助化放疗开始前自我报告MVPA水平达到中度或高度的直肠癌患者的肿瘤缩小率更高。
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Physical activity at diagnosis is associated with tumor downstaging after neoadjuvant chemoradiotherapy in patients with rectal cancer

Background

Patients with rectal cancer are often treated with neoadjuvant chemoradiotherapy, followed by a waiting period and surgical resection. Good or complete response to neoadjuvant chemoradiotherapy might enable organ preservation, which highlights the need to increase response rates. Pre-clinical studies suggest that physical activity during neoadjuvant chemoradiotherapy may improve tumor downstaging.

Purpose

To investigate whether physical activity and physical functioning of patients with rectal cancer at diagnosis are associated with tumor downstaging after neoadjuvant chemoradiotherapy.

Materials and methods

Patients were included if they participated in the Dutch Prospective ColoRectal Cancer Cohort, a nationwide cohort providing an infrastructure for scientific research, and received neoadjuvant chemoradiotherapy for rectal cancer. Tumor downstaging was dichotomized into good/complete or moderate/poor downstaging. Physical activity (total physical activity, moderate-to-vigorous physical activity (MVPA), and Dutch physical activity guideline adherence) and physical functioning were assessed using questionnaires. Logistic regression analyses were performed to examine associations of physical activity and physical functioning with tumor downstaging, adjusted for relevant confounders.

Results

268 patients (aged 62 ± 11 years, 33 % female) with rectal cancer were included. Patients with moderate (OR = 2.07; 95%CI = 1.07 – 4.07; p = 0.03) or high (OR = 2.05; 95%CI = 1.05 – 4.07; p = 0.04) levels of MVPA were more likely to have good/complete tumor downstaging than patients with low levels. No significant associations with tumor downstaging were found for total physical activity, Dutch physical activity guideline adherence, and physical functioning.

Conclusions

We found augmented tumor downstaging in patients with rectal cancer with moderate or high levels of self-reported MVPA before the start of neoadjuvant chemoradiotherapy compared to patients with low levels.

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来源期刊
Radiotherapy and Oncology
Radiotherapy and Oncology 医学-核医学
CiteScore
10.30
自引率
10.50%
发文量
2445
审稿时长
45 days
期刊介绍: Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.
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