诊断后娱乐性有氧运动对乳腺癌幸存者的影响:一项系统综述/ meta分析

IF 3.4
Oliver Wa Wilson, Charles E Matthews, Kaitlyn M Wojcik, Yelena N Tarasenko, Gisela Butera, Jessica Gorzelitz, Clyde Schechter, Jennifer Y Sheng, Jinani Jayasekera
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摘要

我们的目的是评估诊断后娱乐性有氧运动对复发率和死亡率的增量影响,以及可能的影响变化,以支持临床环境中个体化乳腺癌生存护理计划。我们检索了7个数据库,以确定观察性研究,这些研究检查了运动对女性乳腺癌幸存者的复发、乳腺癌特异性死亡率(BCSM)和全因死亡率(ACM)的影响。我们提取了完全调整后的风险比和95%可信区间,用于与不运动/最少运动(参考文献)相关的比较报告。运动和事件之间的剂量-反应关系采用限制三次样条进行检验。不到一半(44.3%,n=50,689)符合有氧运动健康指南(≥~2.5小时/周)。符合指南可使ACM的风险比降低约50%,进一步降低至约4.5小时/周。1小时/周可使ACM的危险比降低25%。5年(未经调整的)ACM发生率为:无运动/最少运动组为11%,运动不足组为4%,达到运动指南组为3% (n=5项研究)。亚组的数据有限。在复发和BCSM中观察到类似的模式。运动可以降低乳腺癌幸存者复发和死亡的风险。虽然达到健康指导方针会带来最大的好处,但低于指导方针的锻炼也是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Post-Diagnosis Recreational Aerobic Exercise among Breast Cancer Survivors: A Systematic Review/Meta-Analyses.

We aimed to estimate the incremental effects of post-diagnosis recreational aerobic exercise, and possible variations in effects, on recurrence and mortality to support individualized breast cancer survivorship care plans in clinical settings. Seven databases were searched to identify observational studies that examined the effects of exercise on recurrence, breast cancer-specific mortality (BCSM), and all-cause mortality (ACM) among female breast cancer survivors. Fully adjusted hazard ratios, and 95% confidence intervals were extracted for comparisons reported in relation to no/minimal exercise (reference). Dose-response relationships between exercise and events were examined using restricted cubic splines. Under half (44.3%, n=50,689) met aerobic exercise guidelines for health (≥~2.5hrs/wk). Meeting guidelines was associated with a ~50% reduction in the hazard ratio for ACM, with further reductions up to ~4.5hrs/wk. A ~25% reduction in the hazard ratio for ACM was associated with ~1hr/wk. The 5-year (unadjusted) ACM rates were 11% for no/minimal exercise, 4% for insufficient exercise, and 3% for meeting exercise guidelines (n=5 studies). There were limited data for subgroups. Similar patterns were observed for recurrence and BCSM. Exercise may lower the risk of recurrence and mortality among breast cancer survivors. Though meeting guidelines for health offers the greatest benefits, exercise below guidelines is also beneficial.

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