Randomized Exercise Trial of Aromatase Inhibitor-Induced Arthralgia in Breast Cancer Survivors
Randomized Exercise Trial of Aromatase Inhibitor-Induced Arthralgia in Breast Cancer Survivors
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DOI：
10.1200/jco.2014.57.1547
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发表时间：
2015-04-01
影响因子：
45.3
通讯作者：
Ligibel, Jennifer
中科院分区：
文献类型：
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作者：
Irwin, Melinda L.;Cartmel, Brenda;Ligibel, Jennifer
目的：在接受芳香酶抑制剂（AIs）治疗的乳腺癌幸存者中，高达50%的人会出现痛感，这是导致AI依从性差的最常见原因。我们对121名接受人工智能治疗并报告关节痛的乳腺癌幸存者进行了为期一年的随机试验，研究运动与常规护理对关节痛严重程度的影响。患者和方法入选标准包括接受人工智能治疗至少6个月，在简短疼痛量表（BPI）中报告最严重关节疼痛>= 3（满分10分），每周报告有氧运动< 90分钟，无力量训练。参与者被随机分配到运动组（每周150分钟有氧运动和每周两次有监督的力量训练）或常规护理组。BPI、西安大略省和麦克马斯特大学骨关节炎（WOMAC）指数以及手臂、肩膀和手的残疾（DASH）问卷分别在基线和3、6、9和12个月完成。采用混合模型重复测量分析评估干预效果，以12个月的变化为主要终点。结果在12个月的时间里，随机分配到运动组的女性（n = 61）参加了70%（+/-标准差[SD]， 28%）的阻力训练，每周增加159分钟（+/-标准差，136分钟）的运动。在12个月时，随机分配到运动组的女性最严重关节疼痛评分下降了1.6分（29%），而接受常规护理的女性则增加了0.2分（3%）（n = 60; P < .001）。在12个月时，随机分配到运动组的女性疼痛严重程度和干扰程度，以及DASH和WOMAC疼痛评分也显著降低，而接受常规护理的女性疼痛评分则升高（均P < 0.001）。结论运动可改善先前不活动的乳腺癌幸存者ai诱导的关节痛。(C) 2014年由美国临床肿瘤学会出版
PurposeArthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity.Patients and MethodsEligibility criteria included receiving an AI for at least 6 months, reporting >= 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point.ResultsOver 12 months, women randomly assigned to exercise (n = 61) attended 70% (+/- standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (+/- SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001).ConclusionExercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors. (C) 2014 by American Society of Clinical Oncology