Effects of exercise interventions on cancer-related fatigue in breast cancer patients: an overview of systematic reviews
Tóm tắt
This overview of systematic reviews aims to critically appraise and consolidate evidence from current systematic reviews (SRs)/meta-analyses on the effects of exercise interventions on cancer-related fatigue (CRF) in breast cancer patients. SRs/meta-analyses that explored the effects of exercise interventions on CRF in breast cancer patients compared with the routine methods of treatment and care were retrieved from nine databases. The methodological quality of the included SRs was appraised using A MeaSurement Tool to Assess systematic Reviews II (AMSTAR II). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to calculate the grading of outcomes in the included SRs. The exercise type, frequency, duration, and inclusion/absence of supervision were further evaluated with subgroup analyses. The Stata 16.0 software was utilized for data analysis. Twenty-nine reviews were included. The overall methodological quality and level of evidence of the included reviews were unsatisfactory, with only three reviews rated as high methodological quality and no review identified as high-quality evidence. Moderate certainty evidence indicated that exercise could improve fatigue in breast cancer patients (SMD = − 0.40 [95%CI − 0.58, − 0.22]; P = 0.0001). Subgroup analysis based on the types of exercise showed that yoga (SMD = − 0.30 [95%CI − 0.56, − 0.05]; I2 = 28.7%) and aerobic exercise (SMD = − 0.29 [95%CI − 0.56, − 0.02]; I2 = 16%) had a significantly better effect on CRF in breast cancer patients; exercising for over 6 months (SMD = − 0.88 [95%CI − 1.59, − 0.17]; I2 = 42.7%; P = 0.0001), three times per week (SMD = − 0.77 [95%CI − 1.04, − 0.05]; I2 = 0%; P = 0.0001), and for 30 to 60 min per session (SMD = − 0.81 [95%CI − 1.15, − 0.47]; I2 = 42.3%; P = 0.0001) can contribute to a moderate improvement of CRF. Supervised exercise (SMD = − 0.48 [95%CI − 0.77, − 0.18]; I2 = 87%; P = 0.001) was shown to relieve CRF. Exercise played a favorable role in alleviating CRF in breast cancer. Yoga was recommended as a promising exercise modality for CRF management in the majority of the included studies. Exercising for at least three times per week with 30 to 60 min per session could be recommended as a suitable dosage for achieving improvement in CRF. Supervised exercise was found to be more effective in alleviating CRF than unsupervised exercise. More rigorously designed clinical studies are needed to specify the exact exercise type, duration, frequency, and intensity to have an optimal effect on CRF in breast cancer patients. ClinicalTrials.gov Identifier: CRD42020219866.
Tài liệu tham khảo
Siegel RL, Miller KD, Fuchs HE et al (2021) Cancer statistics. CA: A Cancer J Clin 71(1):7–33. https://doi.org/10.3322/caac.21654
Bai Y, Xu L, Duan X et al (2020) The Breast Cancer Cohort Study in Chinese Women: research design and preliminary results of clinical multi-center cohort. Chin J Epidemiol 41(12):2046–2052. https://doi.org/10.3760/cma.j.cn112338-20200507-00694
Gradishar WJ, Anderson BO, Abraham J et al (2020) Breast cancer, version 3. NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw 18(4):452–478. https://doi.org/10.6004/jnccn.2020.0016
Fu Z (2020) Comparison of the effect of different chemotherapy regimens in postoperative breast cancer. China Pract Med 15(35):148–150. https://doi.org/10.14163/j.cnki.11-5547/r.2020.35.063
Joly F, Lange M, Dos SM, et al (2019) Long-term fatigue and cognitive disorders in breast cancer survivors. Cancers (Basel) 11(12). https://doi.org/10.3390/cancers1112189
Schmidt ME, Wiskemann J, Armbrust P et al (2015) Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer 137(2):471–480. https://doi.org/10.1002/ijc.29383
Kim S, Han J, Lee MY et al (2020) The experience of cancer-related fatigue, exercise and exercise adherence among women breast cancer survivors: insights from focus group interviews. J Clin Nurs 29(5–6):758–769. https://doi.org/10.1111/jocn.15114
Lenja W, Hiensch AE, Velthuis MJ et al (2018) Four-year effects of exercise on fatigue and physical activity in patients with cancer. BMC Med 16(1):86. https://doi.org/10.1186/s12916-018-1075-x
Gelinas C, Fillion L (2004) Factors related to persistent fatigue following completion of breast cancer treatment. Oncol Nurs Forum 31(2):269–278. https://doi.org/10.1188/04.ONF.269-278
Fabi A, Bhargava R, Fatigoni S et al (2020) Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Ann Oncol 31(6):713–723. https://doi.org/10.1016/j.annonc
Candy B, Jones L, Williams R, et al (2008) Psychostimulants for depression. Cochrane Database Syst Rev (2):CD006722. https://doi.org/10.1002/14651858
Minton O, Richardson A, Sharpe M, et al (2010) Drug therapy for the management of cancer-related fatigue.Cochrane Database Syst Rev (7):D6704. https://doi.org/10.1002/14651858.
Mohandas H, Jaganathan SK, Mani MP et al (2017) Cancer-related fatigue treatment: an overview. J Cancer Res Ther 13(6):916–929. https://doi.org/10.4103/jcrt.JCRT_50_17
Tomlinson D, Robinson PD, Oberoi S et al (2018) Pharmacologic interventions for fatigue in cancer and transplantation: a meta-analysis. Curr Oncol 25(2):e152–e167. https://doi.org/10.3747/co.25.3883
Liu Y, Ouyang Y-Q, Huang Y et al (2019) Meta-analysis of intervention effect of mindfulness-based stress reduction therapy on breast cancer patients. J Nurs 26(8):31–36. https://doi.org/10.16460/j.issn1008-9969.2019.08.031
Eichler C, Pia M, Sibylle M et al (2015) Cognitive behavioral therapy in breast cancer patients—a feasibility study of an 8 week intervention for tumor associated fatigue treatment. Asian Pac J Cancer Prev 16(3):1063–1067. https://doi.org/10.7314/apjcp.2015.16.3.1063
Caspersen CJ, Christenson PGM (1985) Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep (1974-) 100(2):126–131. https://doi.org/10.2307/20056429
Hassett MJ, Somerfield MR, Baker ER et al (2020) Management of male breast cancer: ASCO Guideline. J Clin Oncol 38(16):1849–1863. https://doi.org/10.1200/JCO.19.03120
Hayes SC, Newton RU, Spence RR et al (2019) The Exercise and Sports Science Australia position statement: exercise medicine in cancer management. J Sci Med Sport 22(11):1175–1199. https://doi.org/10.1016/j.jsams.2019.05.003
Kawate T, Yoshida A, Sugae S et al (2021) Recommendations for the management of breast cancer patients during the COVID-19 pandemic from the Japan Breast Cancer Society. Breast Cancer 28(2):247–253. https://doi.org/10.1007/s12282-020-01214-9
Ditsch N, Kolberg-Liedtke C, Friedrich M et al (2021) AGO Recommendations for the diagnosis and treatment of patients with early breast cancer: update 2021. Breast Care (Basel) 16(3):214–227. https://doi.org/10.1159/000516419
Belloni S, Arrigoni C, Caruso R (2021) Effects from physical exercise on reduced cancer-related fatigue: a systematic review of systematic reviews and meta-analysis. Acta Oncol 60(12):1678–1687. https://doi.org/10.1080/0284186X.2021.1962543
Zhu G, Zhang X, Wang Y et al (2016) Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails. Onco Targets Ther 9:2153–2168. https://doi.org/10.2147/OTT.S97864
Vannorsdall TD, Straub E, Saba C et al (2021) Interventions for multidimensional aspects of breast cancer-related fatigue: a meta-analytic review. Supp Care Cancer 29(4):1753–1764. https://doi.org/10.1007/s00520-020-05752-y
Thong M, van Noorden C, Steindorf K et al (2020) Cancer-related fatigue: causes and current treatment options. Curr Treat Options Oncol 21(2):17. https://doi.org/10.1007/s11864-020-0707-5
Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008. https://doi.org/10.1136/bmj.j4008
Zhang F, Shen A, Zeng X et al (2018) An introduction to AMSTAR 2: a critical appraisal tool for systematic reviews. Chin J Evidence-Bases Cardiovasc Med 10(01):14–18. https://doi.org/10.3969/j.issn.1674-4055.2018.01.03
Pussegoda K, Turner L, Garritty C et al (2017) Systematic review adherence to methodological or reporting quality. Syst Rev 6(1):131. https://doi.org/10.1186/s13643-017-0527-2
Hu H, Xu A, Gao C et al (2015) The effect of physical exercise on rheumatoid arthritis: an overview of systematic reviews and meta-analysis. J Adv Nurs (2017) 77(2):506–522. https://doi.org/10.1111/jan.14574
Malmivaara A (2015) Methodological considerations of the GRADE method. Ann Med 47(1):1–5. https://doi.org/10.3109/07853890.2014.969766
Gordon HG, Andrew DO, Gunn EV et al (2009) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Chin J Evid Based Med 9(01):8–11. https://doi.org/10.1136/bmj.39489.470347.AD
Pieper D, Antoine SL, Mathes T et al (2014) Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol 67(4):368–375. https://doi.org/10.1016/j.jclinepi.2013.11.007
Cohen J, Nee JC (1990) Robustness of type I error and power in set correlation analysis of contingency tables. Multivar Behav Res 25(3):341–350. https://doi.org/10.1207/s15327906mbr2503-6
Posadzki P, Pieper D, Bajpai R et al (2020) Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health 20(1):1724. https://doi.org/10.1186/s12889-020-09855-3
Bougioukas KI, Liakos A, Tsapas A et al (2017) Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol 6(93):9–24. https://doi.org/10.1016/j.jclinepi.2017.10.002
Ehlers DK, Dubois K,Salerno EA (2020) The effects of exercise on cancer-related fatigue in breast cancer patients during primary treatment: a meta-analysis and systematic review. Expert Rev Anticancer Ther 1–13. https://doi.org/10.1080/14737140.2020.1813028
Shen Q, Yang H (2020) Impact of post-radiotherapy exercise on women with breast cancer: a systematic review and meta-analysis of randomized controlled trials. J Rehabil Med 52(10):m112. https://doi.org/10.2340/16501977-2740
Lee J, Lee MG (2020) Effects of exercise interventions on breast cancer patients during adjuvant therapy: a systematic review and meta-analysis of randomized controlled trials. Cancer Nurs 43(2):115–125. https://doi.org/10.1097/NCC.0000000000000682
Singh B, Spence RR, Steele ML et al (2018) A systematic review and meta-analysis of the safety, feasibility, and effect of exercise in women with stage II+ breast cancer. Arch Phys Med Rehabil 99(12):2621–2636. https://doi.org/10.1016/j.apmr.2018.03.026
Lipsett A, Barrett S, Haruna F et al (2017) The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis. Breast 32:144–155. https://doi.org/10.1016/j.breast.2017.02.002
Juvet LK, Thune I, Elvsaas IKØ et al (2017) The effect of exercise on fatigue and physical functioning in breast cancer patients during and after treatment and at 6 months follow-up: a meta-analysis. Breast 33:166–177. https://doi.org/10.1016/j.breast.2017.04.003
McNeely ML (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Can Med Assoc J 175(1):34–41. https://doi.org/10.1503/cmaj.051073
Gu L, Yu M, Xu D et al (2012) Effectiveness of physical exercise on health-related quality of life and psychological outcomes in breast cancer patients: a meta analysis. Chin J Pract Nurs 36:58–62. https://doi.org/10.3760/cma.j.issn.1672-7088.2012.36.139
van Vulpen JK, Peeters PHM, Velthuis MJ et al (2016) Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: a meta-analysis. Maturitas 85:104–111. https://doi.org/10.1016/j.maturitas.2015.12.007
Ramírez-Vélez R, Zambom-Ferraresi F, García-Hermoso A et al (2021) Evidence-based exercise recommendations to improve mental wellbeing in women with breast cancer during active treatment: a systematic review and meta-analysis. Cancers (Basel) 13(2):264. https://doi.org/10.3390/cancers13020264
Liu C, Qin M, Zheng X et al (2021) A meta-analysis: intervention effect of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. Evidence-Based Complement Altern Med 2021:9980940. https://doi.org/10.1155/2021/9980940
Lin HP, Kuo YH, Tai WY et al (2021) Exercise effects on fatigue in breast cancer survivors after treatments: a systematic review and meta-analysis. Int J Nurs Pract 2021:e12989. https://doi.org/10.1111/ijn.12989
Duijts SFA, Faber MM, Oldenburg HSA et al (2011) Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psychooncology 20(2):115–126. https://doi.org/10.1002/pon.1728
Liu X, Li H, Guo C et al (2017) Effects of home-based physical activities on the health outcomes in early-stage breast cancer survivors: a meta-analysis. Int J Clin Exp Med 10(11):15129–15139
Zheng F, Li C, Liu Y et al (2021) Meta-analysis of the effects of behavioral intervention in breast cancer patients. Chin J Gerontol 41(02):255–265. https://doi.org/10.3969/j.issn.1005-9202.2021.02.010
Wu Q, Yin Y, Chen L et al (2018) Effects of yoga on negative emotions and quality of life in patients with breast cancer: a meta-analysis. Chin J Med 53(05):559–564. https://doi.org/10.3969/j.issn.1008-1070.2018.05.026
Zhang Q, Piao L, Zhao D et al (2015) Effects of yoga on cancer-related fatigue in breast cancer patients: meta-analysis. Chin J Modern Nurs 21(28):3380–3386. https://doi.org/10.3760/cma.j.issn.1674-2907.2015.28.009
O’Neill M, Mina DS, Sabiston C, et al (2020) The effect of yoga interventions on cancer-related fatigue for breast cancer: a systematic review and meta-analysis of randomized controlled trials. J Clin Oncol 34. https://doi.org/10.1177/1534735420959882
Dong B, Xie C, Jing X et al (2019) Yoga has a solid effect on cancer-related fatigue in patients with breast cancer: a meta-analysis. Breast Cancer Res Treat 177(1):5–16. https://doi.org/10.1007/s10549-019-05278-w
Hsueh EJ, Loh EW, Lin JJ et al (2021) Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer 28(2):264–276. https://doi.org/10.1007/s12282-020-01209-6
Xu H-Y, Zhang L-D, Yang H (2020) Meta analysis of the effects of aerobic exercise on cancer-related fatigue in breast cancer patients. Chin Med Pharm 10(08):23–27. https://doi.org/10.3969/j.issn.2095-0616.2020.08.006
Hu Y, Gu P, Zhang X (2009) Effectiveness of rehabilitation program on shoulder function of breast cancer patients after mastectomy: a systematic review. Chin J Evid Based Med 9(01):41–54. https://doi.org/10.3969/j.issn.1672-2531.2009.01.012
Yang D, Guo J-H, Zhang J (2019) Effects of aerobic exercise on cancer-related fatigue in breast cancer patients: a meta-analysis. J Modern Clin Med 45(04):288–292. https://doi.org/10.11851/j.issn.1673-1557.2019.04.016
Zhang Y, Liang M (2012) Meta-analysis of the effect of aerobic exercise on cancer-induced fatigue in breast cancer patients. Chin Med Modern Dist Educ China 10(13):122–123. https://doi.org/10.3969/j.issn.1672-2779.2012.13.077
Zou L, Yang L, He X et al (2014) Effects of aerobic exercise on cancer-related fatigue in breast cancer patients receiving chemotherapy: a meta-analysis. Chin Gen Pract 17(13):1524–1528. https://doi.org/10.3969/j.issn.1007-9572.2014.13.020
Luo X, Liu J, Fu J, et al (2020) Effect of tai chi chuan in breast cancer patients: a systematic review and meta-analysis. Front Oncol 10(607). https://doi.org/10.3389/fonc.2020.00607
Liu L, Tan H, Yu S, et al. (2020). The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complement Ther Clin Pract 38(101078). https://doi.org/10.1016/j.ctcp.2019.101078
Guyatt GH, Oxman AD, Vist G et al (2011) GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol 64(4):407–415. https://doi.org/10.1016/j.jclinepi.2010.07.017
Guyatt GH, Oxman AD, Montori V et al (2011) GRADE guidelines: 5. Rating the quality of evidence—publication bias. J Clin Epidemiol 64(12):1277–1282. https://doi.org/10.1016/j.jclinepi.2011.01.011
Guyatt GH, Oxman AD, Kunz R et al (2011) GRADE guidelines: 6. Rating the quality of evidence—imprecision. J Clin Epidemiol 64(12):1283–1293. https://doi.org/10.1016/j.jclinepi.2011.01.012
Guyatt GH, Oxman AD, Kunz R et al (2011) GRADE guidelines: 7. Rating the quality of evidence—inconsistency. J Clin Epidemiol 64(12):1294–1302. https://doi.org/10.1016/j.jclinepi.2011.03.017
Guyatt GH, Oxman AD, Kunz R et al (2011) GRADE guidelines: 8. Rating the quality of evidence—indirectness. J J Clin Epidemiol 64(12):1303–1310. https://doi.org/10.1016/j.jclinepi.2011.04.014
Tumor Support and Rehabilitation Therapy Group the Oncology Committee of Chinese Medical Association (2021) Clinical practice guidelines for cancer-related fatigue in China (2021 edition). China Oncol 31(9):852–872. https://doi.org/10.19401/j.cnki.1007-3639.2021.09.012
Lin PJ, Kleckner IR, Loh KP et al (2019) Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: a nationwide, multicenter randomized controlled trial of yoga in cancer survivors. Integr Cancer Ther 18:1871073566. https://doi.org/10.1177/1534735419855134
Piercy KL, Troiano RP, Ballard RM et al (2018) The physical activity guidelines for Americans. JAMA 320(19):2020–2028. https://doi.org/10.1001/jama.2018.14854
Yao L, Ma J, Ji C et al (2021) Research progress of application of kinesitherapy in cancer-related fatigue in patients with breast cancer. Chin J Modern Nurs 27(02):159–163. https://doi.org/10.3760/cma.j.cn115682-20200630-04141
Mock V, Atkinson A, Barsevick A et al (2000) NCCN practice guidelines for cancer-related fatigue. Oncology (Williston Park, NY) 14(11A):151–161
Zhang Y, Zhang J (2016) Influence of aerobic exercise combined with relaxation therapy on symptom clusters and quality of life of breast cancer patients with chemotherapy. Chin Nurs Res 30(22):2764–276. https://doi.org/10.3969/j.issn.1009-6493.2016.22.0197
Wang H, Long Y, Chen X (2020) The thinking and suggestion of scientific research interest conflict. Public Commun Sci Technol 12(21):52–55. https://doi.org/10.16607/j.cnki.1674-6708.2020.21.018