背景:心脏毒性是化疗最常见的不良事件之一。体育锻炼被证明具有心脏保护作用。我们旨在评估接受心脏毒性化疗的癌症患者运动的疗效和安全性。
方法:我们对随机对照试验(RCT)进行了系统评价和荟萃分析,通过系统地搜索PubMed来检索,WebofScience,Scopus,科克伦,临床试验.gov,和MedRxiv到7月17日,2023年。我们使用RevManV.5.4汇集使用风险比(RR)的二分数据和使用平均差(MD)的连续数据,95%置信区间(CI)。
■CRD42023460902。
结果:我们纳入了13个RCTs,共952例患者。运动显着增加VO2峰值(MD:1.95,95%CI[0.59,3.32],P=0.005)。然而,对左心室射血分数没有显著影响,全局纵向应变,心输出量,每搏输出量,左心室舒张末期容积,左心室收缩末期容积,E/A比,静息心率,峰值心率,静息收缩压,和静息舒张压.此外,关于任何不良事件(AE)没有显着差异(RR:4.44,95%CI[0.47,41.56],P=0.19),导致退出的不良事件(RR:2.87,95%CI[0.79,10.43],P=0.11),严重不良事件(RR:3.00,95%CI[0.14,65.90],P=0.49),或全因死亡率(RR:0.25,95%CI[0.03,2.22],P=0.21)。
结论:运动与接受心脏毒性化疗的癌症患者VO2峰值升高相关。然而,在超声心动图和安全性结局方面,运动治疗和常规治疗没有显著差异.
BACKGROUND: Cardiotoxicity is one of the most common adverse events of the chemotherapy. Physical exercise was shown to be cardioprotective. We aim to estimate the efficacy and safety of exercise in cancer patients receiving
cardiotoxic chemotherapy.
METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, Cochrane, Clinical Trials.gov, and MedRxiv through July 17th, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI).
UNASSIGNED: CRD42023460902.
RESULTS: We included thirteen RCTs with a total of 952 patients. Exercise significantly increased VO2 peak (MD: 1.95 with 95% CI [0.59, 3.32], P = 0.005). However, there was no significant effect regarding left ventricular ejection fraction, global longitudinal strain, cardiac output, stroke volume, left ventricular end-diastolic volume, left ventricular end-systolic volume, E/A ratio, resting heart rate, peak heart rate, resting systolic blood pressure, and resting diastolic blood pressure. Also, there was no significant difference regarding any adverse events (AEs) (RR: 4.44 with 95% CI [0.47, 41.56], P = 0.19), AEs leading to withdrawal (RR: 2.87 with 95% CI [0.79, 10.43], P = 0.11), serious AEs (RR: 3.00 with 95% CI [0.14, 65.90], P = 0.49), or all-cause mortality (RR: 0.25 with 95% CI [0.03, 2.22], P = 0.21).
CONCLUSIONS: Exercise is associated with increased VO2 peak in cancer patients receiving
cardiotoxic chemotherapy. However, there was no significant difference between exercise and usual care regarding the echocardiographic and safety outcomes.