Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy
Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy
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DOI：
10.1093/ajcn/65.5.1495
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发表时间：
1997-05-01
影响因子：
7.1
通讯作者：
Winer, EP
中科院分区：
文献类型：
--
作者：
DemarkWahnefried, W;Hars, V;Winer, EP
体重增加是接受辅助化疗的乳腺癌患者的常见副作用，可能会降低生活质量并损害生存率。治疗期间的体重增加是一个众所周知的问题，许多研究者已经对其进行了研究。然而，很少有对照研究已经进行，以确定原因来解释这种明显的能量不平衡。进行了一项探索性研究，以量化接受辅助化疗的乳腺癌患者能量摄入和能量消耗特定成分的潜在变化。研究假设是在女性接受辅助化疗期间观察到静息代谢率（RMR）降低。招募了20例绝经前I期或II期乳腺癌患者，接受环磷酰胺+多柔比星+ 5-氟尿嘧啶;环磷酰胺+甲氨蝶呤+ 5-氟尿嘧啶+/-多柔比星;多柔比星+环磷酰胺+/-甲酰四氢叶酸;或甲氨蝶呤+ 5-氟尿嘧啶+甲酰四氢叶酸化疗。在开始治疗前和整个治疗过程中评估RMR、饮食诱导的产热、能量摄入、体力活动和身体成分。18例受试者的完整数据表明，RMR从基线到治疗中期显著降低（P = 0.02），并在化疗完成时反弹至与基线相似的水平。总体而言，与基线水平相比，治疗期间体力活动和能量摄入水平也显著降低（分别为P = 0.04和P = 0.03）。这些发现表明，化疗引起身体成分和代谢要求的许多显着变化。这一领域的其他研究将为创造最佳干预措施以抑制乳腺癌妇女的体重增加提供有价值的见解。
Weight gain, a common side effect among breast cancer patients receiving adjuvant chemotherapy, may decrease quality of life and impair survival. Weight gain during treatment is a well-known problem and has been studied by many investigators. However, few controlled studies have been conducted to determine reasons to explain this apparent energy imbalance. An exploratory study was undertaken to quantitate potential changes in energy intake and specific components of energy expenditure in breast cancer patients receiving adjuvant chemotherapy. The research hypothesis was that a reduction in resting metabolic rate (RMR) would be observed during the period in which women received adjuvant chemotherapy. Twenty premenopausal patients with stage I or II breast cancer and receiving cyclophosphamide + doxorubicin + 5-fluorouracil; cyclophosphamide + methotrexate + 5-fluorouracil +/- doxorubicin; doxorubicin + cyclophosphamide +/- leucovorin; or methotrexate + 5-fluorouracil + leucovorin chemotherapy were recruited. RMR, diet-induced thermogenesis, energy intake, physical activity, and body composition were assessed before the initiation and throughout the course of therapy, Complete data on 18 subjects suggest that RMR decreased significantly from baseline to midtreatment (P = 0.02) and rebounded to levels similar to those at baseline on completion of chemotherapy. Overall, levels of physical activity and energy intake also decreased significantly during treatment compared with baseline levels (P = 0.04 and P = 0.03, respectively). These findings suggest that chemotherapy provokes many significant changes in body composition and metabolic requirements. Additional research in this area will provide valuable insight into creating optimal interventions to curb weight gain in women with breast cancer.