不同运动干预对头颈部肿瘤患者影响的meta分析  

Meta-analysis of the effects of different exercise interventions on head and neck cancer survivors

作　　者：田甜 刘艳琳 张洁 王娟[2] Tian Tian;Liu Yanlin;Zhang Jie;Wang Juan(School of Nursing,Gansu University of Traditional Chinese Medicine,Gansu 730000,China;Head and Neck II Department,Gansu Provincial Cancer Hospital,Gansu 730050,China)

机构地区：[1]甘肃中医药大学护理学院,甘肃730000 [2]甘肃省肿瘤医院头颈二科,甘肃730050

出　　处：《中华放射肿瘤学杂志》2025年第2期128-135,共8页Chinese Journal of Radiation Oncology

基　　金：国家重点专科建设项目(甘财社[2021]80号);甘肃省头颈肿瘤临床医学研究中心项目(21JR7RA678)。

摘　　要：目的评价运动干预对接受放疗、化疗、同步放化疗的头颈部肿瘤患者疲劳、生活质量、身体功能的影响。方法检索Embase、Web of Science、PubMed、Cochrane Library、万方数据库和中国知网等数据库,时间范围为建库至2024年4月。由2名研究人员独立筛选文献、提取资料、使用物理治疗证据数据库量表进行文献质量评估,采用RevMan 5.4软件进行统计分析。主要结局指标有肿瘤相关疲劳、6 min步行距离、体重指数、去脂体重。结果纳入12篇文献,共710例患者。PEDro量表评分为5~8分。meta分析结果显示,运动干预能够缓解肿瘤相关疲劳[标准化均数差(SMD)=-0.90,95%CI为-1.33~-0.48,P<0.001],延长6 min步行距离(SMD=0.84,95%CI为0.05~1.62,P=0.040),改善身体成分,降低体重指数(SMD=-0.36,95%CI为-0.66~-0.07),P=0.020),对去脂体重的增加无统计学意义(SMD=0.32,95%CI为-0.11~0.74,P=0.130)。亚组分析结果显示,采取有氧结合阻力训练(SMD=-1.12,95%CI为-1.46~-0.79,I 2=0%)和伸展训练(SMD=-0.90,95%CI为-1.56~-0.25,I 2=75%)可更有效缓解疲劳,有氧结合阻力训练(SMD=1.23,95%CI为0.28~2.18,I 2=89%)对6 min步行距离延长的效果最佳,接受放化疗(SMD=-1.34,95%CI为-1.67~-1.01,I 2=47%)和化疗(SMD=-1.12,95%CI为-1.80~-0.45)的患者运动干预后疲劳改善效果更为明显,同时接受放化疗(SMD=1.14,95%CI为0.81~1.48,I 2=0%)和化疗(SMD=2.62,95%CI为1.98~3.25)者经运动干预后,6 min步行距离延长的效果更佳。结论运动干预对缓解头颈部肿瘤患者肿瘤相关疲劳、延长6 min步行距离、改善生活质量及降低体重指数有较为显著的效果。Objective To evaluate the effects of exercise interventions on fatigue,quality of life and physical function in head and neck cancer patients receiving radiotherapy,chemotherapy and simultaneous radiochemotherapy.Methods Embase,Web of Science,PubMed,Cochrane Library,Wanfang Database and CNKI,databases were searched with the timeframe from the establishment of the database to April 2024.Two researchers independently screened the literature,extracted information,assessed the quality of literature using the Physiotherapy Evidence Database(PEDro)scale,and statistically analyzed using RevMan 5.4 software.The main outcome indexes included cancer-related fatigue,6 min walking distance(6MWD),body mass index(BMI)and fat-free mass.Results A total of 12 articles involving 710 patients were included.PEDro scale scores were ranged from 5 to 8.Meta-analysis showed that exercise interventions relieved cancer-related fatigue[standard mean difference(SMD)=-0.90,95%CI=-1.33 to-0.48,P<0.001],prolonged 6MWD(SMD=0.84,95%CI=0.05 to 1.62,P=0.040),improved body composition,reduced BMI(SMD=-0.36,95%CI=-0.66 to-0.70,P=0.020),and had no statistical significance for the increase of fat-free mass(SMD=0.32,95%CI=-0.11 to 0.74,P=0.130).Subgroup analyses showed that taking aerobic combined with resistance training(SMD=-1.12,95%CI=-1.46 to-0.79,I 2=0%)and stretching(SMD=-0.90,95%CI=-1.56 to-0.25,I 2=75%)were more effective in relieving fatigue,aerobic combined with resistance training interventions(SMD=1.23,95%CI=0.28 to 2.18,I 2=89%)was the most effective in extending the 6MWD.Patients receiving radiochemotherapy(SMD=-1.34,95%CI=-1.67 to-1.01,I 2=47%)and chemotherapy(SMD=-1.12,95%CI=-1.80 to-0.45)showed more significant improvement in relieving cancer-related fatigue after exercise interventions.Those receiving radiochemotherapy(SMD=1.14,95%CI=0.81 to 1.48,I 2=0%)and chemotherapy(SMD=2.62,95%CI=1.98 to 3.25)showed even better results in prolonging 6MWD after exercise interventions.Conclusion Exercise intervention has a significant improvement e

关 键 词：运动 头颈部肿瘤 放射疗法 化学疗法 放化疗 疲劳 生活质量 

分 类 号：R739.91[医药卫生—肿瘤]