Background/Objectives:Early-stage breast cancer treatments adversely affect components of health-related fitness (HRF) important for treatment tolerability, recovery, and long-term outcomes. Few studies have examined cancer treatment modality-specific effects on HRF. We examined associations of breast cancer treatment modalities, regimens, and combinations with one-year changes in HRF.Methods:Newly diagnosed early-stage breast cancer patients were recruited between 2012 and 2019 for the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. HRF assessments were completed within 90 days of diagnosis and at one year, including cardiorespiratory fitness, muscle strength and endurance, and body composition. Analysis of covariance was used to test whether HRF changes differed between treatment modalities, regimens, and combinations. All tests were 2-sided.Results:A total of 1350 participants (mean [SD] age, 55.6 [10.7] years) were included. Women who received chemotherapy (n = 797; 59%) experienced statistically significant smaller increases in upper body strength (−1.7 kg, 95% confidence interval [CI]: −3.0 to −0.5), greater declines in lower body endurance (−118.0 kg, 95%CI: −216.6 to −19.3), and greater declines in total lean mass (−0.7 kg, 95%CI: −1.1 to −0.3), bone mineral density (−0.01 g/cm2, 95%CI: −0.02 to 0.00), and bone mineral content (0.04 kg, 95%CI: −0.06 to −0.02). Other treatment modalities were modestly and inconsistently associated with HRF changes. Treatment combinations that included chemotherapy had the most negative impact on cardiorespiratory fitness and body composition.Conclusions:Chemotherapy—either alone or in combination with other treatments—had the largest and broadest negative impact on HRF recovery in early-stage breast cancer at one-year follow-up.
背景/目的：早期乳腺癌治疗会对健康相关体能（HRF）的多个方面产生不利影响，这些方面对治疗耐受性、康复及长期预后至关重要。目前针对不同癌症治疗模式对HRF影响的研究较少。本研究旨在探讨乳腺癌治疗模式、方案及其组合与HRF一年变化之间的关联。 方法：2012年至2019年间，新诊断的早期乳腺癌患者被招募参与阿尔伯塔乳腺癌运动康复（AMBER）队列研究。分别在确诊后90天内及一年后完成HRF评估，包括心肺适能、肌肉力量与耐力以及身体成分。采用协方差分析检验不同治疗模式、方案及组合间的HRF变化差异。所有检验均为双侧检验。 结果：共纳入1350名参与者（平均[标准差]年龄55.6[10.7]岁）。接受化疗的女性（n=797；59%）在上肢力量增长（-1.7 kg，95%置信区间[CI]：-3.0至-0.5）、下肢耐力下降（-118.0 kg，95%CI：-216.6至-19.3）、总瘦体重下降（-0.7 kg，95%CI：-1.1至-0.3）、骨密度下降（-0.01 g/cm²，95%CI：-0.02至0.00）及骨矿物质含量下降（-0.04 kg，95%CI：-0.06至-0.02）方面均呈现统计学显著变化。其他治疗模式与HRF变化的关联较弱且不一致。包含化疗的治疗组合对心肺适能和身体成分的负面影响最为显著。 结论：在一年随访期内，化疗（无论是单独使用还是与其他治疗联合）对早期乳腺癌患者HRF恢复的负面影响最为广泛且显著。
Associations of Breast Cancer Treatments with One-Year Changes in Health-Related Fitness
肿瘤(癌症)患者之家