Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline
Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline
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DOI：
10.1200/jco.22.00687
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发表时间：
2022-08-01
影响因子：
45.3
通讯作者：
Alfano, Catherine M.
中科院分区：
文献类型：
--
作者：
Ligibel, Jennifer A.;Bohlke, Kari;Alfano, Catherine M.
目的 为成人积极癌症治疗期间的运动、饮食和体重管理提供指导。 方法 对文献进行系统回顾，确定系统评价和随机对照试验，评估有氧运动和抗阻运动、特定饮食和食物以及成人在癌症治疗期间有意减轻体重和避免体重增加对生活质量、治疗毒性和癌症控制的影响。从 2000 年 1 月到 2021 年 5 月检索了 PubMed 和 Cochrane 图书馆。ASCO 召集了一个专家小组来审查证据并制定建议。 结果证据库包括 52 项系统评价（42 项关于运动，9 项关于饮食，1 项关于体重管理），以及另外 23 项随机对照试验。最常研究的癌症类型是乳腺癌、前列腺癌、肺癌和结直肠癌。癌症治疗期间的锻炼可以改善心肺健康、力量、疲劳和其他患者报告的结果。肺癌患者的术前锻炼可减少术后住院时间和并发症。中性粒细胞减少饮食不会降低癌症治疗期间的感染风险。建议肿瘤科医生应建议在积极治疗期间定期进行有氧运动和阻力运动，并可能建议接受肺癌手术的患者进行术前运动。不建议通过中性粒细胞减少饮食来预防癌症患者在积极治疗期间的感染。癌症治疗期间其他饮食和减肥干预措施的证据非常有限。该指南讨论了特殊考虑因素，例如晚期癌症患者的锻炼，并强调了在该领域进行更多研究的迫切需要，特别是在癌症治疗期间的饮食和减肥干预方面。 (C) 2022 美国临床肿瘤学会
PURPOSE To provide guidance on exercise, diet, and weight management during active cancer treatment in adults.METHODS A systematic review of the literature identified systematic reviews and randomized controlled trials evaluating the impact of aerobic and resistance exercise, specific diets and foods, and intentional weight loss and avoidance of weight gain in adults during cancer treatment, on quality of life, treatment toxicity, and cancer control. PubMed and the Cochrane Library were searched from January 2000 to May 2021. ASCO convened an Expert Panel to review the evidence and formulate recommendations.RESULTS The evidence base consisted of 52 systematic reviews (42 for exercise, nine for diet, and one for weight management), and an additional 23 randomized controlled trials. The most commonly studied types of cancer were breast, prostate, lung, and colorectal. Exercise during cancer treatment led to improvements in cardiorespiratory fitness, strength, fatigue, and other patient-reported outcomes. Preoperative exercise in patients with lung cancer led to a reduction in postoperative length of hospital stay and complications. Neutropenic diets did not decrease risk of infection during cancer treatment.RECOMMENDATIONS Oncology providers should recommend regular aerobic and resistance exercise during active treatment with curative intent and may recommend preoperative exercise for patients undergoing surgery for lung cancer. Neutropenic diets are not recommended to prevent infection in patients with cancer during active treatment. Evidence for other dietary and weight loss interventions during cancer treatment was very limited. The guideline discusses special considerations, such as exercise in individuals with advanced cancer, and highlights the critical need for more research in this area, particularly regarding diet and weight loss interventions during cancer treatment. (C) 2022 by American Society of Clinical Oncology