摘要
目的探讨消化道恶性肿瘤生存者体能锻炼行为模式的改变和临床意义。方法采用回顾分析的方法,调查手术、化放疗后病情稳定的70岁以上Ⅰ～Ⅲ期消化道恶性肿瘤(食管癌、胃癌和结肠直肠癌)生存者,记录其诊断前、积极治疗3个月和1年的运动量和每周运动频率,并了解患者运动动机和偏好,探讨运动与肿瘤复发的关系。结果调查了72例消化道恶性肿瘤生存者,发现患者经治疗病情平稳后进行中、高强度运动的频率比诊断之前低,但1年后平均轻度和中等强度体力活动基本达到诊断前水平,而高强度锻炼频率仍低。根据指南,运动基本达标的患者占65.3%,肿瘤复发率为12.8%,不达标的患者占34.7%,复发率为16.0%,运动不达标时肿瘤复发的风险比(RR)为1.80(95%CI 0.95～3.41,P=0.04),有统计学意义。肿瘤生存者运动的动机主要有改善健康、增加体能,维持正常生活方式、增加免疫力等,而最常见的运动障碍是疲乏、缺少动机和不舒服等。结论初步研究表明,治疗期间恶性肿瘤生存者的体能锻炼参与比例下降,治疗完成后中轻度锻炼基本恢复到诊断前的水平,而高强度活动能力仍低,锻炼达到标准者较未达标者肿瘤复发率降低,(P=0.04),有统计学意义。
Objective To explore the effect physical exercise change on eldly gastric-intestinal cancer survivors. Methods Elderly gastric-intestinal cancer （gastric cancer, esophagus cancer, and colonrectal cancer） survivors who had progression-free disease after surgeD＇, chemotherapy, and/or radiation therapy were included. Their physical exercises and participation rates per week before cancer diagnosis, 3 months after anti-cancer therapy, and 1 year after diagnosis as well as their exercise motivations and prevalences were retrospectively investigated. Results Totally 72 elderly gastric- interstenal cancer survivors were enrolled. Moderate to vigorous intensity exercise participation rate decreased from prediagnosis to postdiagnosis among the progressin-free elderly gastric-interstenal cancer survivors, while the participation rate of light to moderate intensity exercise was restored 1 year after diagnosis. Amang them 65.3% （47/72） patients had exercise up to the standard and the cancer recurrence rate was 12. 8% （6/47）. The recurrence rate of the other group was 16.0% （9/25）, and the risk ratio of recurrence was 1. 80 （95% CI： 0.95-3.41） （P=0.04）. The most common motivations among exercise among survivors were to improve health, increase energy, maintain a normal life style, and improve their immune functions. The main disturbances were fatigue, feeling of illness, and lack of motivation. Conclusion The physical exercise participation rate among the elderly gastric-intestine cancer survivors decreases during anticancer treatment. Their light to moderate intensity exercise participation rate returns to prediagnosis levels, while their vigorous intensity exercise participation rate will not restore after their treatments are accoplished. The exercise seems to decrease the recurrence rate of cancer.
出处
《癌症进展》
2010年第1期13-17,共5页
Oncology Progress
基金
2007年首都医学发展基金资助联合公关项目资助:常见恶性肿瘤生存者生存者医院社区治疗模式研究(项目编号:2007-1049)
