The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis.
The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis.
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DOI：
10.2147/ndt.s150464
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发表时间：
2018
影响因子：
3.2
通讯作者：
van der Feltz-Cornelis CM
中科院分区：
文献类型：
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作者：
Kessels E;Husson O;van der Feltz-Cornelis CM
这项研究的目的是进行系统的回顾和荟萃分析，以确定运动干预对癌症幸存者癌症相关性疲劳(CRF)的影响，并与非运动干预对照组进行比较。通过PubMed数据库检索和参考文献检索，纳入2000年1月1日至2016年8月17日发表的临床试验。在没有接受姑息治疗的癌症幸存者中，合格的试验比较了运动干预对CRF的影响与非运动干预对照组，CRF为主要结果，并通过有效的自我报告问卷进行衡量。我们根据Cochrane质量标准评估了个体试验的偏倚风险。在以干预类型、运动强度、依从性和癌症类型为调节变量的低风险偏倚试验中，我们进行了随机效应荟萃分析，并进行了包括高偏倚试验在内的Meta回归分析和敏感性分析。在274项试验中，11项符合纳入标准，其中6项偏倚风险较低。运动改善慢性肾功能衰竭的作用大(Cohen‘s d 0.605，95%CI 0.235-0.975)，在不同癌症类型之间没有显著差异。有氧运动的效果(Δ=1.009，CI 0.222~1.797)明显高于有氧运动和阻力运动的组合(Δ=0.341，CI 0.129~0.552)。主持人和元回归分析显示，高依从性产生最好的改善。运动对癌症幸存者的CRF有很大影响。高依从性的有氧干预效果最佳。
The objective of the study was to conduct systematic review and meta-analysis to establish the effect of exercise interventions on cancer-related fatigue (CRF) in cancer survivors, compared to non-exercise intervention controls. Trials published between January 1st 2000 and August 17th 2016 were included through PubMed database search and search of references. Eligible trials compared the effect of an exercise intervention on CRF compared to non-exercise intervention controls, with CRF as primary outcome and measured by validated self-report questionnaire, in cancer survivors not receiving palliative care. We evaluated risk of bias of individual trials following Cochrane Quality criteria. We performed a random-effects meta-analysis in the low risk of bias trials with intervention type, exercise intensity, adherence, and cancer type as moderators, and also performed meta-regression analyses and a sensitivity analysis including the high risk of bias trials. Out of 274 trials, 11 met the inclusion criteria, of which six had low risk of bias. Exercise improved CRF with large effect size (Cohen’s d 0.605, 95% CI 0.235–0.975) with no significant difference between types of cancer. Aerobic exercise (Δ=1.009, CI 0.222–1.797) showed a significantly greater effect than a combination of aerobic and resistance exercises (Δ=0.341, CI 0.129–0.552). Moderator and meta-regression analyses showed high adherence yielding best improvements. Exercise has a large effect on CRF in cancer survivors. Aerobic interventions with high adherence have the best result.