Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial.
Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial.
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DOI：
10.1016/j.clcc.2017.06.001
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发表时间：
2018-03
影响因子：
3.4
通讯作者：
Schmitz KH
中科院分区：
文献类型：
--
作者：
Brown JC;Troxel AB;Ky B;Damjanov N;Zemel BS;Rickels MR;Rhim AD;Rustgi AK;Courneya KS;Schmitz KH
观察性研究表明，在结肠癌幸存者中，更高的体力活动量与疾病复发的风险较低相关。然而，为结肠癌幸存者规定更高强度的体力活动的可行性和安全性尚不清楚。此外，运动减少疾病复发的途径尚不清楚。I-III期结肠癌幸存者被随机分为常规护理对照组、150 min·wk−1有氧运动组（低剂量）或300 min·wk−1有氧运动组（高剂量）。检测可溶性细胞间粘附分子-1（sICAM-1）和血管粘附分子-1（sVCAM-1）预后生物标志物的变化。从2015年1月至2016年2月，39例患者入组（n=13例常规护理对照; n=14例低剂量; n=12例高剂量），38例参与者完成了研究（97%随访）。在6个月的时间里，低剂量组完成了142 min·wk−1（92.8%的依从性），高剂量组完成了247 min·wk−1（89.0%的依从性）的运动。与对照组相比，低剂量组sICAM-1的变化为−134.9 ng/mL（95% CI：−238.1至−31.6），高剂量组为−114.8 ng/mL（95% CI：−222.5至−7.1）（线性P趋势=0.023;非线性P趋势=0.044）。未观察到sVCAM-1的变化（线性P趋势=0.791;非线性P趋势=0.604）。非严重不良事件在随机分组中的发生率相似。未发生严重不良事件。在近期接受治疗的I-III期结肠癌患者中，更高量的中等强度有氧运动（高达300 min·wk−1）是可行的、安全的，并能引起预后生物标志物的有利变化。这些数据可用于指导患者的临床建议，并为未来的试验提供信息。
Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among colon cancer survivors. However, the feasibility and safety of prescribing higher volumes of physical activity to colon cancer survivors are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Stage I–III colon cancer survivors were randomized to usual-care control, 150 min·wk−1 of aerobic exercise (low-dose), or 300 min·wk−1 of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 (sICAM-1) and vascular adhesion molecule-1 (sVCAM-1) prognostic biomarkers were examined. From January 2015 to February 2016, 39 patients were enrolled (n=13 usual-care control; n=14 low-dose; n=12 high-dose) and 38 participants completed the study (97% follow-up). Over six-months, the low-dose group completed 142 min·wk−1 (92.8% adherence) and the high-dose group completed 247 min·wk−1 (89.0% adherence) of exercise. Compared to the control group, changes in sICAM-1 were −134.9 ng/mL (95% CI: −238.1 to −31.6) in the low-dose group and −114.8 ng/mL (95% CI: −222.5 to −7.1) in the high-dose group (linear Ptrend=0.023; nonlinear Ptrend=0.044). No changes were observed for sVCAM-1 (linear Ptrend=0.791; nonlinear Ptrend=0.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Higher volumes of moderate-intensity aerobic exercise, up to 300 min·wk−1, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I–III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.
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