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举报
2014-01-15 08:36
初译
Exercise dampens aromatase inhibitor–related joint pain 锻炼可减轻芳香酶抑制剂引起的关节疼痛 http://www.internalmedicinenews.com/specialty-focus/oncology-hematology/single-article-page/exercise-dampens-aromatase-inhibitor-related-joint-pain/33383ff19a0cd42399a7cf8590708ebf.html SAN ANTONIO – Adopting a standard exercise program resulted in a clinically meaningful 30% reduction in aromatase inhibitor-associated joint pain in breast cancer patients who participated in a year-long randomized trial. SAN ANTONIO---在参与一整年随机试验的乳腺癌患者中采用一种标准锻炼程序可以使芳香酶抑制剂引起的关节疼痛临床意义上有30%的缓解。 The exercise prescription utilized in the HOPE (Hormones and Physical Exercise) trial was what’s recommended in national guidelines both for cancer survivors and healthy adults: 150 minutes per week of at least moderate-intensity aerobic activity, such as brisk walking, along with two strength-training sessions per week, Melinda L. Irwin, Ph.D., explained at the San Antonio Breast Cancer Symposium. 运动处方利用HOPE(激素和体育锻炼)方案，该方案是全国性针对癌症幸存者和健康成人的推荐方案；每周至少150min的中等强度的有氧运动，例如快走，连同每周两次力量训练，Melinda L. Irwin，哲学博士，在San Antonio 乳腺癌研讨会上解释说。 The HOPE studies enrolled 121 postmenopausal women who had stage 1-3, hormone receptor–positive breast cancers and were physically inactive and overweight yet physically able to exercise. At enrollment, they were experiencing moderate aromatase inhibitor (AI)–associated joint pain, defined as a score of 5-7 on the 0-10 Brief Pain Inventory (BPI), after about 18 months on the medication. Roughly two-thirds of participants had no history of joint pain prior to starting AI therapy; the rest reported the AI exacerbated their preexisting joint pain. Subjects were randomized to the exercise program or to usual care, which included written information about the importance of exercise. 这项HOPE 研究招募了121名1-3级，激素受体阳性的乳腺癌绝经妇女，她们都是不喜欢运动，超重，但有运动的能力。在注册实验过程中，她们都有中等程度的芳香酶抑制剂引起的关节疼痛，以0-10 BPI评分都在5-7.在大约18个月的辅助处理后，大约有三分之二的参与者与之前开始AI治疗有关节疼痛历史相比没有关节疼痛了；其余的则报道AI加重了她们已有的关节疼痛。受试者是随机分组到运动组或者是常规护理组，常规护理组包括关于运动重要性的书面告知。 The primary study endpoint was the 12-month change in BPI worst pain score, which dropped by an average of 30% among the exercise group. This translated to an improvement in pain level from moderate at baseline to mild at follow-up. In addition, BPI scores rating pain severity and pain interference improved by about 20%. In contrast, patients in the usual care control group experienced a slight increase in BPI scores in all three domains over time, added Dr. Irwin, co-leader of the cancer prevention and control research program at Yale University Cancer Center, New Haven, Conn. 该研究的第一个终止点是12个月后的BPI更高疼痛评分的改变，这在运动组中大约平均下降了30%。这表明疼痛水平从基线的中等水平下降到随后的缓和水平。另外，BPI得分评定疼痛的严重程度和疼痛干预提高了大约20%。相反的是，常规护理对照组的病人在这三个方面随着时间的推移BPI评分有轻微的上升，Irwin博士补充说，他是耶鲁大学癌症中心癌症预防和控制研究项目的共同领导者。 The HOPE results received an enthusiastic audience reception. Physicians were particularly impressed with the 70% exercise adherence rate over the course of a year. They asked how they can keep their previously sedentary patients’ commitment to regular exercise from waning after an initial burst of enthusiasm, as so often happens. HOPE的结果得到了一个热情的读者的采纳，内科医生特别印象深刻的是有70%的参与者在一年的训练后仍然继续了这项锻炼。他们想知道如何能让之前习惯久坐的病人开始有规则的锻炼，即使在开始爆发的热情消退之后，正如经常发生的那样。 Dr. Irwin replied that adherence to lifestyle change is always a challenge. Social support is quite helpful. The exercise group in HOPE received a paid gym membership and met in small groups with a personal trainer twice weekly. Irwin博士回复说坚持改变一种生活方式也是一个挑战。社会的支持是很重要的。在HOPE试验中运动小组接受了一个付费的体育馆会员项目以小组的方式配备私人教练每周锻炼两次。 "The women really bonded with each other. And there are now a growing number of free programs throughout the country, which give cancer survivors a start on an exercise program with a free gym membership for several months. For example, the Livestrong Foundation has partnered with the YMCA to offer free exercise programs for cancer survivors at local Ys," she said. “这些妇女真的相互依赖。现在整个国家这种免费项目越来越多，他们会给癌症幸存者在运动项目中几个月的免费健身房会员资格，这只是一个开始。例如，Livestrong 基金会和YMCA相互合作给Ys本地的癌症幸存者提供免费的运动项目。”她说。 The HOPE trial was funded by the National Cancer Institute. Dr. Irwin reported having no financial conflicts of interest. This degree of improvement in joint pain is greater than reported in studies of glucosamine, acupuncture, or vitamin D supplementation, she noted. HOPE实验是由国家癌症协会资助。Irwin 博士报告说没有资助利益冲突。这种关节疼痛程度的改善比其它报道的辅助治疗如葡糖按，针灸，或者是维生素D效果都要好，她强调说。 The improvement in pain scores in the exercise group was greater at 12 months than at 3 or 6, suggesting that a year-long exercise program is probably necessary to see sustained reduction in joint pain. 参与实验12个月在运动组疼痛评分的改善比3或者6个月要高很多，这表明一整年的运动方案对于持续降低关节的疼痛是有必要的。 At 12 months of follow-up, women in the exercise group averaged 159 minutes of physical activity per week, 110 minutes more than controls. Compliance with the supervised exercise program was notably good, with women attending an average of 70% of the twice-weekly small-group strength-training sessions. 在12个月之后，在运动组的妇女每周都会坚持159分钟的运动，比对照组要多出110分钟。顺应监护下运动项目是很好的，有70%的妇女参加了每周两次的小组力量训练课程。 In addition to the improvement in AI-related arthralgias, the exercise group experienced ancillary benefits: a mean 6.5% improvement in peak oxygen consumption, or VO2 max, compared with baseline, along with a 3% reduction in body weight. 除了AI相关的关节疼痛的改善，运动小组也有其他的收获：与基线相比高峰氧耗量（VO2 max）提高了6.5%，同时体重也有3%的下降。 HOPE was the first randomized trial to examine the effects of exercise on AI side effects in breast cancer patients. The impetus for the study was the recognition that arthralgias are the most common reason for poor adherence to and discontinuation of AI therapy. Up to 20% of breast cancer patients discontinue their AI within the first year. And both early discontinuation and poor adherence have been shown to be predictive of increased mortality risk. HOPE是第一个随机对照试验来检验运动对乳腺癌患者AI副作用的影响。开展这项研究主要是因为关节疼是AI治疗不能坚持和较低认可度最常见的原因。有20%的乳腺癌患者在第一年终止了他们的AI治疗。而早期终止治疗和较低认可度是死亡率增加的前兆。 |
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举报
2014-01-12 00:59
编译
锻炼可减轻芳香酶抑制剂引起的关节疼痛 SAN ANTONIO---在参与一整年随机试验的乳腺癌患者中采用一种标准锻炼程序可以使芳香酶抑制剂引起的关节疼痛临床意义上有30%的缓解。 运动处方利用HOPE(激素和体育锻炼)方案，该方案是全国性针对癌症幸存者和健康成人的推荐方案；每周至少150min的中等强度的有氧运动，例如快走，连同每周两次力量训练，Melinda L. Irwin，哲学博士，在San Antonio 乳腺癌研讨会上解释说。 这项HOPE 研究招募了121名1-3级，激素受体阳性的乳腺癌绝经妇女，她们都是不喜欢运动，超重，但有运动的能力。在注册实验过程中，她们都有中等程度的芳香酶抑制剂引起的关节疼痛，以0-10 BPI评分都在5-7.在大约18个月的辅助处理后，大约有三分之二的参与者与之前开始AI治疗有关节疼痛历史相比没有关节疼痛了；其余的则报道AI加重了她们已有的关节疼痛。受试者是随机分组到运动组或者是常规护理组，常规护理组包括关于运动重要性的书面告知。 该研究的第一个终止点是12个月后的BPI更高疼痛评分的改变，这在运动组中大约平均下降了30%。这表明疼痛水平从基线的中等水平下降到随后的缓和水平。另外，BPI得分评定疼痛的严重程度和疼痛干预提高了大约20%。相反的是，常规护理对照组的病人在这三个方面随着时间的推移BPI评分有轻微的上升，Irwin博士补充说，他是耶鲁大学癌症中心癌症预防和控制研究项目的共同领导者。 HOPE的结果得到了一个热情的读者的采纳，内科医生特别印象深刻的是有70%的参与者在一年的训练后仍然继续了这项锻炼。他们想知道如何能让之前习惯久坐的病人开始有规则的锻炼，即使在开始爆发的热情消退之后，正如经常发生的那样。 Irwin博士回复说坚持改变一种生活方式也是一个挑战。社会的支持是很重要的。在HOPE试验中运动小组接受了一个付费的体育馆会员项目以小组的方式配备私人教练每周锻炼两次。 “这些妇女真的相互依赖。现在整个国家这种免费项目越来越多，他们会给癌症幸存者在运动项目中几个月的免费健身房会员资格，这只是一个开始。例如，Livestrong 基金会和YMCA相互合作给Ys本地的癌症幸存者提供免费的运动项目。”她说。 HOPE实验是由国家癌症协会资助。Irwin 博士报告说没有资助利益冲突。这种关节疼痛程度的改善比其它报道的辅助治疗如葡糖按，针灸，或者是维生素D效果都要好，她强调说。 参与实验12个月在运动组疼痛评分的改善比3或者6个月要高很多，这表明一整年的运动方案对于持续降低关节的疼痛是有必要的。 在12个月之后，在运动组的妇女每周都会坚持159分钟的运动，比对照组要多出110分钟。顺应监护下运动项目是很好的，有70%的妇女参加了每周两次的小组力量训练课程。 除了AI相关的关节疼痛的改善，运动小组也有其他的收获：与基线相比高峰氧耗量（VO2 max）提高了6.5%，同时体重也有3%的下降。 HOPE是第一个随机对照试验来检验运动对乳腺癌患者AI副作用的影响。开展这项研究主要是因为关节疼是AI治疗不能坚持和较低认可度最常见的原因。有20%的乳腺癌患者在第一年终止了他们的AI治疗。而早期终止治疗和较低认可度是死亡率增加的前兆。 字数:1142 |
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