Background/ObjectivesThis systematic review and network meta-analysis aimed to determine the most effective therapeutic exercise modality for improving quality of life (QoL) in patients with advanced-stage cancer. Specifically, the study compared the effects of aerobic training, strength training, and combined aerobic and strength training on QoL outcomes.MethodsA systematic literature search was conducted in PubMed, Embase, Cochrane Reviews, and the Cochrane Central Register of Controlled Trials up to 24 February 2023. The review adhered to PRISMA guidelines. Included studies were randomized controlled trials (RCTs) involving adult patients with advanced-stage cancers (e.g., pancreatic, colorectal, lung, breast, prostate, gastrointestinal, gynecological, hematological, head and neck, melanoma, or cancers with bone metastases). The primary outcome was post-intervention QoL, while the secondary outcome assessed was the dropout rate across exercise modalities.ResultsAerobic training demonstrated the greatest improvement in QoL with a standardized mean difference (SMD) of 0.30 (95% CI: 0.00 to 0.61), followed by strength training (SMD = 0.13; 95% CI: −0.41 to 0.66) and combined training (SMD = 0.07; 95% CI: −0.11 to 0.24). However, none of the interventions showed statistically significant superiority. Dropout rates were comparable across all exercise modalities and control groups, suggesting strong adherence and feasibility of these interventions in advanced cancer populations.ConclusionsWhile all exercise modalities were associated with improved QoL in patients with advanced-stage cancer, no single intervention emerged as significantly superior. Aerobic exercise may offer a slight advantage, although this effect was not statistically significant. These results highlight the importance of individualized exercise prescriptions based on patient preference, functional status, and treatment context. Further research is warranted to identify patient subgroups that may benefit most from specific exercise interventions and to explore QoL subdomains such as fatigue, emotional well-being, and physical functioning.
背景/目的 本系统综述与网状荟萃分析旨在确定改善晚期癌症患者生活质量（QoL）最有效的运动治疗方式。研究具体比较了有氧训练、力量训练以及有氧与力量联合训练对生活质量的影响。 方法 截至2023年2月24日，系统检索了PubMed、Embase、Cochrane Reviews及Cochrane对照试验中心注册库的相关文献。本综述遵循PRISMA指南。纳入的研究均为随机对照试验（RCT），涉及成年晚期癌症患者（如胰腺癌、结直肠癌、肺癌、乳腺癌、前列腺癌、胃肠道癌、妇科癌症、血液系统肿瘤、头颈部肿瘤、黑色素瘤或伴有骨转移的癌症）。主要结局指标为干预后的生活质量，次要结局指标为不同运动方式的退出率。 结果 有氧训练对生活质量的改善最为明显，标准化均数差（SMD）为0.30（95% CI：0.00至0.61），其次是力量训练（SMD = 0.13；95% CI：−0.41至0.66）和联合训练（SMD = 0.07；95% CI：−0.11至0.24）。然而，所有干预方式均未显示出统计学上的显著优势。各运动组与对照组的退出率相近，表明这些干预措施在晚期癌症患者中具有较好的依从性和可行性。 结论 尽管所有运动方式均与晚期癌症患者生活质量的改善相关，但未发现单一干预方式具有显著优越性。有氧运动可能略具优势，但该效果未达到统计学显著性。这些结果强调了基于患者偏好、功能状态及治疗背景制定个体化运动方案的重要性。未来需进一步研究以明确哪些患者亚群可能从特定运动干预中获益最大，并深入探讨生活质量的具体维度，如疲劳、情绪状态和躯体功能。
肿瘤(癌症)患者之家