立即进行与健康相关的生活质量的患者的延迟运动，开始了雄激素剥夺疗法：长达一年的随机试验的结果
Immediate Versus Delayed Exercise on Health-related Quality of Life in Patients Initiating Androgen Deprivation Therapy: Results from a Year-long Randomised Trial
影响因子:9.30000
分区:医学1区 Top / 泌尿学与肾脏学1区 肿瘤学2区
发表日期:2025 Apr
作者:
Dennis R Taaffe, Robert U Newton, Suzanne K Chambers, Christian J Nelson, Nigel Spry, Hao Luo, Oliver Schumacher, David Joseph, Robert A Gardiner, Dickon Hayne, Daniel A Galvão
摘要
在前列腺癌（PCA），功能损害和与健康相关的生活质量（HRQOL）的患者中，雄激素剥夺治疗（ADT）导致了一系列与治疗相关的毒性。已经证明了运动可以抵消许多这些不良反应，包括降低HRQOL。但是，应在锻炼时不太清楚。这项研究的目的是检查在治疗期间开始进行ADT时开始运动是否在对抗HRQOL的不良影响方面是否更有效地使用PCA（48 - 84年）启动ADT的启动ADT立即进行（IMEX; n = 54）或延迟运动（DEL; n = 48）。 IMEX由6个MO的监督性/有氧/冲击运动组成，该运动在ADT启动时开始使用6 mo随访。 DEL由6个月的通常护理组成，然后是同一运动计划的6个月。使用基线和6和12 mo的短表格-36评估HRQOL。 Intention to treat was utilised for the analyses that included group × time repeated-measures analysis of variance using log transformed data.There were a significant group × time interaction for the physical functioning domain (p = 0.045) and physical component summary score (p = 0.005), and a significant time effect for bodily pain (p < 0.001) and vitality domains (p < 0.001), with HRQoL maintained in IMEX and declining in DEL在6个月。在DEL中进行运动的逆转性下降的活力和物理成分摘要得分的下降，与基线相比，在12个月的差异没有差异。局限性包括干预期间的治疗改变。持续进行PCA患者的运动和ADT保存HRQOL，而在某些HRQOL领域的既定ADT方案逆转下进行的运动开始下降，以避免在治疗开始时对生命的初始治疗不良治疗对生活的不良影响对生活的不良影响。
Abstract
An array of treatment-related toxicities result from androgen deprivation therapy (ADT) in patients with prostate cancer (PCa), compromising function and health-related quality of life (HRQoL). Exercise has been demonstrated to counter a number of these adverse effects including decreased HRQoL; however, when exercise should be initiated is less clear. This study aims to examine whether commencing exercise when ADT is initiated rather than later during treatment is more effective in countering adverse effects on HRQoL.Men with PCa (48-84 yr) initiating ADT were randomised to immediate exercise (IMEX; n = 54) or delayed exercise (DEL; n = 48) for 12 mo. IMEX consisted of 6 mo of supervised resistance/aerobic/impact exercise commenced at the initiation of ADT with 6 mo of follow-up. DEL consisted of 6 mo of usual care followed by 6 mo of the same exercise programme. HRQoL was assessed using the Short Form-36 at baseline and 6 and 12 mo. Intention to treat was utilised for the analyses that included group × time repeated-measures analysis of variance using log transformed data.There were a significant group × time interaction for the physical functioning domain (p = 0.045) and physical component summary score (p = 0.005), and a significant time effect for bodily pain (p < 0.001) and vitality domains (p < 0.001), with HRQoL maintained in IMEX and declining in DEL at 6 mo. Exercise in DEL reversed declines in vitality and in the physical component summary score, with no differences at 12 mo compared with baseline. Limitations include treatment alterations during the intervention.Concurrently initiating exercise and ADT in patients with PCa preserves HRQoL, whereas exercise initiated while on established ADT regimens reverses declines in some HRQoL domains.To avoid initial treatment-related adverse effects on health-related quality of life, exercise medicine should be initiated at the start of treatment.