运动对乳腺癌幸存者认知功能的影响：随机对照试验的系统回顾和荟萃分析。

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-06-14 DOI:10.1007/s00520-025-09647-8

Victor Hugo G Pinheiro, Stephanie S Pinto, Pâmela S Cardozo, Luana S Andrade, Cristine L Alberton

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引用次数: 0

摘要

目的：癌症相关认知障碍（CRCI）是乳腺癌幸存者中常见的副作用。新出现的证据表明，锻炼可能有助于控制CRCI。本系统综述和荟萃分析评估了运动项目对乳腺癌幸存者认知功能的影响。方法：检索PubMed、Cochrane、Embase和Web of Science于2023年5月检索的随机对照试验（RCTs）。两名独立审稿人使用Rayyan平台，根据预定义的资格标准（包括标题/摘要和全文筛选）对研究进行筛选和选择。使用Cochrane风险偏倚2工具评估研究质量。在R中使用“meta”包进行meta分析，比较实验组和对照组在干预后的认知领域和自我报告的认知结果。结果：890名乳腺癌幸存者的11项随机对照试验显示，运动对注意力和工作记忆有显著影响(SMD为0.43,95% CI [0.20；0.66], p < 0.001, I²= 51%)，执行功能(SMD = -0.29, 95% CI [-0.46；-0.13], p < 0.001, I²= 0%)，感知认知能力(SMD 0.95, 95% CI [0.32；1.57], p = 0.003, I²= 69%)，认知抱怨(SMD -0.75, 95% CI [-1.07；-0.44], p < 0.001, I²= 0%)。结论：这一荟萃分析的系统综述表明，运动可以改善乳腺癌幸存者的认知功能，特别是注意力、工作记忆、执行功能和自我报告的认知结果。然而，认知评估工具的异质性突出表明需要进一步标准化，包括联合使用有效的自我报告问卷和神经心理学测试，以及更加强调认知功能作为主要结果，以增强可比性和加强证据基础。对癌症幸存者的启示：运动项目应纳入幸存者护理，以解决CRCI，支持认知健康，并提高整体生活质量。

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The effect of exercise on cognitive function in breast cancer survivors: systematic review and meta-analysis of randomized controlled trials.

Purpose: Cancer-related cognitive impairment (CRCI) is a common side effect among breast cancer survivors. Emerging evidence suggests that exercise may help manage CRCI. This systematic review and meta-analysis evaluated the impact of exercise programs on cognitive function in breast cancer survivors.

Methods: PubMed, Cochrane, Embase, and Web of Science were searched in May 2023 for randomized controlled trials (RCTs). Two independent reviewers conducted the screening and selection of studies based on predefined eligibility criteria, including title/abstract and full-text screening, using the Rayyan platform. Study quality was assessed using the Cochrane Risk of Bias 2 tool. Meta-analyses were conducted in R using the "meta" package, comparing experimental and control groups for cognitive domains and self-reported cognitive outcomes post-intervention.

Results: Eleven RCTs with 890 breast cancer survivors showed significant exercise effects on attention and working memory (SMD 0.43, 95% CI [0.20; 0.66], p < 0.001, I² = 51%), executive function (SMD -0.29, 95% CI [-0.46; -0.13], p < 0.001, I² = 0%), perceived cognitive abilities (SMD 0.95, 95% CI [0.32; 1.57], p = 0.003, I² = 69%), and cognitive complaints (SMD -0.75, 95% CI [-1.07; -0.44], p < 0.001, I² = 0%).

Conclusion: This systematic review with meta-analysis demonstrates that exercise improves cognitive function in breast cancer survivors, particularly attention, working memory, executive function, and self-reported cognitive outcomes. However, the heterogeneity in cognitive assessment tools underscores the need for greater standardization, including the combined use of validated self-report questionnaires and neuropsychological tests, as well as a stronger emphasis on cognitive function as a primary outcome, to enhance comparability and strengthen the evidence base.

Implications for cancer survivors: Exercise programs should be integrated into survivorship care to address CRCI, support cognitive health, and improve overall quality of life.

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.