众所周知，合理运动可以改善早期乳腺癌患者的生理和心理健康、疾病和治疗相关不良反应。不同的运动方式，具有不同的作用，例如有氧运动主要用于提高耐力、减轻体重（减肥），抗阻运动主要用于提高肌力、增加肌肉（健美）。对于不同的早期乳腺癌患者，需要专业康复师制定不同的运动方案。不过，有关早期乳腺癌化疗患者运动方式的随机对照研究极少，长期随访更少。
2019年3月26日，施普林格·自然旗下《乳腺癌研究与治疗》在线发表瑞典卡罗林学院（与很多学院改称大学相反，该学院是目前全世界最大的独立医科大学，创建于1810年，自1977年起全权负责评审并颁发诺贝尔生理学或医学奖）及其附属医院的OptiTrain随机对照研究报告，比较了早期乳腺癌化疗患者两种运动方式与常规护理的健康相关结局两年随访结果。
OptiTrain: Optimal Training for Women With Breast Cancer During Chemotherapy Treatment (NCT02522260)
该三分组随机对照研究于2013年3月～2016年7月入组年龄18～70岁被诊断为I～IIIa期乳腺癌接受化疗女性206例，随机分入三组分别参加16周：
高强度间歇有氧运动＋循序渐进的抗阻运动（RT-HIIT组，79例）
高强度间歇有氧运动＋中强度持续有氧运动（AT-HIIT组，80例）
常规护理（UC组，81例）
入组后两年时分别评定患者的癌症相关疲劳、生活质量、症状、肌肉力量、心肺健康、体重、体力活动、久坐行为、病假天数。
结果，入组后两年时，RT-HIIT组与UC组相比：
癌症相关疲劳总体评分较低：-1.37（95%置信区间：-2.70～-0.04，效应量：-0.06）
癌症相关疲劳认知评分较低：-1.47（95%置信区间：-2.75～-0.18，效应量：-0.28）
下肢肌力较高：+12.09（95%置信区间：+3.77～+20.40，效应量：0.52）
其他指标相似
此外，入组后两年时，AT-HIIT组与UC组相比：
症状总体评分较低：-0.23（95%置信区间：-0.42～-0.03，效应量：-0.15）
症状负荷评分较低：-0.30（95%置信区间：-0.60～-0.01，效应量：-0.19）
体重较低：-2.15（95%置信区间：-3.71～-0.60，效应量：-0.28）
其他指标相似
因此，该研究结果表明，对于早期乳腺癌化疗患者，不同运动组与常规护理相比，两年后的RT-HIIT组癌症相关疲劳和肌肉力量、AT-HIIT组症状和体重显著改善。这些结果证实早期乳腺癌女性化疗期间参加运动可以长期获益，但是需要由专业人员制定不同的运动方案帮助患者保持运动水平。
相关阅读
Breast Cancer Res Treat. 2019 Mar 26.
Two-year follow-up of the OptiTrain randomised controlled exercise trial.
Kate A. Bolam, Sara Mijwel, Helene Rundqvist, Yvonne Wengstrom.
Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
PURPOSE: The aim of this study was to determine if there were any differences in health-related outcomes and physical activity (PA) between the two OptiTrain exercise groups and usual care (UC), 2 years post-baseline.
METHODS: The OptiTrain study was a three-arm randomised controlled trial comparing 16 weeks of concurrent aerobic high-intensity interval training (HIIT) and progressive resistance exercise (RT-HIIT) or concurrent HIIT and continuous moderate-intensity aerobic exercise (AT-HIIT) to UC in 206 patients with breast cancer undergoing chemotherapy. Eligible participants were approached 2 years following baseline to assess cancer-related fatigue, quality of life, symptoms, muscle strength, cardiorespiratory fitness, body mass, PA, sedentary behaviour, and sick leave.
RESULTS: The RT-HIIT group reported lower total cancer-related fatigue, (-1.37, 95% CI -2.70, -0.04, ES=-0.06) and cognitive cancer-related fatigue (-1.47, 95% CI -2.75, -0.18, ES=-0.28), and had higher lower limb muscle strength (12.09, 95% CI 3.77, 20.40, ES=0.52) than UC at 2 years. The AT-HIIT group reported lower total symptoms (-0.23, 95% CI -0.42, -0.03, ES=-0.15), symptom burden (-0.30, 95% CI -0.60, -0.01, ES=-0.19), and body mass -2.15 (-3.71, -0.60, ES=-0.28) than UC at 2 years.
CONCLUSION: At 2 years, the exercise groups were generally experiencing positive differences in cancer-related fatigue (RT-HIIT), symptoms (AT-HIIT), and muscle strength (RT-HIIT) to UC. The findings provide novel evidence that being involved in an exercise program during chemotherapy can have long-term benefits for women with breast cancer, but that strategies are needed to create better pathways to support patients to maintain physical activity levels.
TRIAL REGISTRATION: Clinicaltrials.gov registration number: NCT02522260
KEYWORDS: Breast cancer Exercise Fatigue Chemotherapy Physical activity Long-term effects
DOI: 10.1007/s10549-019-05204-0
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