癌症治疗期间的运动、饮食和体重管理:ASCO指南

SCI

1 June 2022

Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline

(Journal of Clinical Oncology; IF：44.544)

Purpose 目的

To provide guidance on exercise, diet, and weight management during active cancer treatment in adults.

为成人积极癌症治疗期间的运动、饮食和体重管理提供指导。

Methods 方法

A systematic review of the literature identified systematic reviews and randomized controlled trials evaluating the impact of aerobic and resistance exercise, specific diets and foods, and intentional weight loss and avoidance of weight gain in adults during cancer treatment, on quality of life, treatment toxicity, and cancer control. PubMed and the Cochrane Library were searched from January 2000 to May 2021. ASCO convened an Expert Panel to review the evidence and formulate recommendations.

通过一项对文献的系统综述筛选了了系统综述和随机对照试验，评估了成年人在癌症治疗期间有氧和抗阻力运动、特定饮食和食物、意向性减肥和避免体重增加对生活质量、治疗毒性和癌症控制的影响。搜索PubMed和Cochrane图书馆从2000年1月到2021年5月的文献。ASCO召集了一个专家小组来审查证据并制定建议。

Results 结果

The evidence base consisted of 52 systematic reviews (42 for exercise, nine for diet, and one for weight management), and an additional 23 randomized controlled trials. The most commonly studied types of cancer were breast, prostate, lung, and colorectal. Exercise during cancer treatment led to improvements in cardiorespiratory fitness, strength, fatigue, and other patient-reported outcomes. Preoperative exercise in patients with lung cancer led to a reduction in postoperative length of hospital stay and complications. Neutropenic diets did not decrease risk of infection during cancer treatment.

证据基础包括52个系统评价(42个关于运动，9个关于饮食，1个关于体重管理)和另外23个随机对照试验。最常研究的癌症类型是乳腺癌、前列腺癌、肺癌和结直肠癌。癌症治疗期间的锻炼导致心肺健康、力量、疲劳和其他患者报告的结果的改善。肺癌患者术前运动可减少术后住院时间和并发症。中性饮食并不能降低癌症治疗期间的感染风险。

Recommendations 推荐

Oncology providers should recommend regular aerobic and resistance exercise during active treatment with curative intent and may recommend preoperative exercise for patients undergoing surgery for lung cancer. Neutropenic diets are not recommended to prevent infection in patients with cancer during active treatment. Evidence for other dietary and weight loss interventions during cancer treatment was very limited. The guideline discusses special considerations, such as exercise in individuals with advanced cancer, and highlights the critical need for more research in this area, particularly regarding diet and weight loss interventions during cancer treatment.

肿瘤科医师应建议在积极治疗期间定期进行有氧和抗阻力运动，并建议接受肺癌手术的患者在术前进行运动。不建议中性饮食来预防癌症患者在积极治疗期间的感染。癌症治疗期间其他饮食和减肥干预措施的证据非常有限。该指南讨论了一些特殊的考虑因素，如晚期癌症患者的锻炼，并强调了在这一领域进行更多研究的必要性，特别是在癌症治疗期间的饮食和减肥干预方面。