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【medical-news】【资讯翻译】运动可减少芳香酶抑制...

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【medical-news】【资讯翻译】运动可减少芳香酶抑制剂相关性关节痛
举报 2014-01-07 13:59
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举报 2014-01-07 21:31
Exercise dampensaromatase inhibitor–related joint pain
运动减轻芳香化酶抑制剂相关的关节炎痛。
SANANTONIO –Adopting a standard exercise program resulted in a clinically meaningful 30%reduction in aromatase inhibitor-associated joint pain in breast cancerpatients who participated in a year-long randomized trial.
The exercise prescription utilized in the HOPE(Hormones and Physical Exercise) trial was what’s recommended in nationalguidelines both for cancer survivors and healthy adults: 150 minutes per weekof at least moderate-intensity aerobic activity, such as brisk walking, alongwith two strength-training sessions per week, Melinda L. Irwin, Ph.D.,explained at the San Antonio Breast Cancer Symposium.
圣安东尼奥-一项乳腺癌病人参与的为期一年的随机试验表明,采用标准的锻炼计划可以使芳香化酶抑制剂相关的关节疼痛减轻30%。哲学博士Melinda L. Irwin在圣安东尼奥乳腺癌峰会上说,HOPE(激素与身体锻炼)的锻炼处方遵循成人及生存者锻炼指南:每周150分钟至少为中等强度的有氧运动,如快步走、每周2次的力量训练。
The HOPE studiesenrolled 121 postmenopausal women who had stage 1-3, hormone receptor–positivebreast cancers and were physically inactive and overweight yet physically ableto 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 PainInventory (BPI), after about 18 months on the medication. Roughly two-thirds ofparticipants had no history of joint pain prior to starting AI therapy; therest reported the AI exacerbated their preexisting joint pain. Subjects wererandomized to the exercise program or to usual care, which included writteninformation about the importance of exercise.
HOPE研究共纳入121名分期为1-3期、激素受体阳性的绝经后乳腺癌女性,他们平时缺乏锻炼、体重超标,但体能均能胜任锻炼计划。这些研究对象在AI(芳香化酶抑制剂)治疗18个月后均出现AI相关中度关节疼痛(按照0-10分级的简明疼痛量表,她们的评分为5-7分)。大约2/3的患者在AI治疗前没有关节疼病史。研究对象(包括锻炼重要性的书面信息)随机分配为接受锻炼计划组、一般照料组。
The primary study endpoint was the 12-monthchange in BPI worst pain score, which dropped by an average of 30% among theexercise group. This translated to an improvement in pain level from moderateat baseline to mild at follow-up. In addition, BPI scores rating pain severityand pain interference improved by about 20%. In contrast, patients in the usualcare control group experienced a slight increase in BPI scores in all threedomains over time, added Dr. Irwin, co-leader of the cancer prevention andcontrol research program at Yale University CancerCenter, New Haven, Conn.
主要研究终点是12个月后按照BPI得出的最高疼痛评分,锻炼组评分平均下降30%。这可以视为疼痛减轻,从基线水平的中度疼痛改善为随访时的轻度疼痛。此外,BPI评估的疼痛严重程度及疼痛继发影响下降了20%。Irwin(纽黑文市耶鲁大学癌症预防与控制研究计划的合作带头人)补充说,与此相反,随时间推移,纳入一般照料措施的对照组所有三个疼痛评估部位的BPI积分均有轻微增加
This degree of improvement in joint pain isgreater than reported in studies of glucosamine, acupuncture, or vitamin Dsupplementation, she noted.
她补充说,关节痛的缓解程度要优于其它研究中氨基葡萄糖、针灸、VD补充等措施带来的效果。
The improvement in pain scores in the exercisegroup was greater at 12 months than at 3 or 6, suggesting that a year-longexercise program is probably necessary to see sustained reduction in jointpain.
12个月时疼痛评分的下降要优于3个月、6个月,表明长达一年锻炼计划对长期减轻关节疼痛很可能是必要的。
At 12 months of follow-up, women in theexercise group averaged 159 minutes of physical activity per week, 110 minutesmore than controls. Compliance with the supervised exercise program was notablygood, with women attending an average of 70% of the twice-weekly small-groupstrength-training sessions.
In addition to the improvement in AI-relatedarthralgias, 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.
随访至12个月时,锻炼组女性平均每周活动159分钟,比对照组高出110分钟。遵循监督锻炼计划的益处是显而易见的:每周2次的力量训练计划的参与度达到70%。除了AI相关关节疼痛的减轻,锻炼组有额外获益:与基线相比,峰值氧耗量或称最大氧耗量下降6.5%,体重下降3%。
HOPE was the first randomized trial to examinethe effects of exercise on AI side effects in breast cancer patients. The impetusfor the study was the recognition that arthralgias are the most common reasonfor poor adherence to and discontinuation of AI therapy. Up to 20% of breastcancer patients discontinue their AI within the first year. And both earlydiscontinuation and poor adherence have been shown to be predictive ofincreased mortality risk.
The HOPE results received an enthusiasticaudience reception. Physicians were particularly impressed with the 70%exercise adherence rate over the course of a year. They asked how they can keeptheir previously sedentary patients’ commitment to regular exercise from waningafter an initial burst of enthusiasm, as so often happens.
HOPE是第一个检验锻炼如何影响AI对乳腺癌病人的不良反应的试验。研究的动力来自以下认识:关节疼痛是不能坚持或中断AI治疗的最常见原因。高达20%的病人在AI治疗的第一年中断治疗。早期治疗中断及不能坚持治疗被证实可预测死亡风险的增加。HOPE的研究结果获得了热情读者的认可。内科医师主要关注的是一年期锻炼计划有70%的的坚持,他们想知道,在最初热情过后,如何让缺乏锻炼的病人坚持长期规律锻炼。
Dr. Irwin replied that adherence to lifestylechange is always a challenge. Social support is quite helpful. The exercisegroup in HOPE received a paid gym membership and met in small groups with apersonal trainer twice weekly.
"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 gymmembership for several months. For example, the Livestrong Foundation haspartnered with the YMCA to offer free exercise programs for cancer survivors atlocal Ys," she said.
Irwin说,坚持改变生活方式是一个挑战,但社会的支持可起帮助作用。HOPE的锻炼组成为付费健身房会员,并以小组形式每周2次与私人教练会面;这些女性也相互监督。现在整个国家的免费项目不断增加,对癌症生存者锻炼计划开始的最初几个月提供免费会员资格,例如,坚强活着基金会与YMCA(基督教青年会)合作为癌症生存者提供免费锻炼计划。
The HOPE trial was funded by the NationalCancer Institute. Dr. Irwin reported having no financial conflicts of interest.
HOPE研究由国立癌症研究院赞助,Irwin声称不存在经济利益冲突。
举报 2014-01-07 21:32
编译:1066字
运动减轻芳香化酶抑制剂相关的关节炎痛。
圣安东尼奥-一项乳腺癌病人参与的为期一年的随机试验表明,采用标准的锻炼计划可以使芳香化酶抑制剂相关的关节疼痛减轻30%。哲学博士Melinda L. Irwin在圣安东尼奥乳腺癌峰会上说,HOPE(激素与身体锻炼)的锻炼处方遵循成人及生存者锻炼指南:每周150分钟至少为中等强度的有氧运动,如快步走、每周2次的力量训练。
HOPE研究共纳入121名分期为1-3期、激素受体阳性的绝经后乳腺癌女性,他们平时缺乏锻炼、体重超标,但体能均能胜任锻炼计划。这些研究对象在AI(芳香化酶抑制剂)治疗18个月后均出现AI相关中度关节疼痛(按照0-10分级的简明疼痛量表,她们的评分为5-7分)。大约2/3的患者在AI治疗前没有关节疼病史。研究对象(包括锻炼重要性的书面信息)随机分配为接受锻炼计划组、一般照料组。
主要研究终点是12个月后按照BPI得出的最高疼痛评分,锻炼组评分平均下降30%。这可以视为疼痛减轻,从基线水平的中度疼痛改善为随访时的轻度疼痛。此外,BPI评估的疼痛严重程度及疼痛继发影响下降了20%。Irwin(纽黑文市耶鲁大学癌症预防与控制研究计划的合作带头人)补充说,与此相反,随时间推移,纳入一般照料措施的对照组所有三个疼痛评估部位的BPI积分均有轻微增加
她补充说,关节痛的缓解程度要优于其它研究中氨基葡萄糖、针灸、VD补充等措施带来的效果。
12个月时疼痛评分的下降要优于3个月、6个月,表明长达一年锻炼计划对长期减轻关节疼痛很可能是必要的。
随访至12个月时,锻炼组女性平均每周活动159分钟,比对照组高出110分钟。遵循监督锻炼计划的益处是显而易见的:每周2次的力量训练计划的参与度达到70%。除了AI相关关节疼痛的减轻,锻炼组有额外获益:与基线相比,峰值氧耗量或称最大氧耗量下降6.5%,体重下降3%。
HOPE是第一个检验锻炼如何影响AI对乳腺癌病人的不良反应的试验。研究的动力来自以下认识:关节疼痛是不能坚持或中断AI治疗的最常见原因。高达20%的病人在AI治疗的第一年中断治疗。早期治疗中断及不能坚持治疗被证实可预测死亡风险的增加。HOPE的研究结果获得了热情读者的认可。内科医师主要关注的是一年期锻炼计划有70%的的坚持,他们想知道,在最初热情过后,如何让缺乏锻炼的病人坚持长期规律锻炼。
Irwin说,坚持改变生活方式是一个挑战,但社会的支持可起帮助作用。HOPE的锻炼组成为付费健身房会员,并以小组形式每周2次与私人教练会面;这些女性也相互监督。现在整个国家的免费项目不断增加,对癌症生存者锻炼计划开始的最初几个月提供免费会员资格,例如,坚强活着基金会与YMCA(基督教青年会)合作为癌症生存者提供免费锻炼计划。
HOPE研究由国立癌症研究院赞助,Irwin声称不存在经济利益冲突。
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