Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis

医学 前列腺癌 荟萃分析 不利影响 随机对照试验 内科学 癌症 相对风险 物理疗法 生活质量(医疗保健) 心理信息 梅德林 置信区间 政治学 护理部 法学
作者
Liam Bourke,Dianna Smith,Liz Steed,Richard Hooper,Anouska Carter,James W.F. Catto,Peter C. Albertsen,Bertrand Tombal,Heather Payne,Derek J. Rosario
出处
期刊:European Urology [Elsevier BV]
卷期号:69 (4): 693-703 被引量:265
标识
DOI:10.1016/j.eururo.2015.10.047
摘要

Exercise could be beneficial for prostate cancer survivors. However, no systematic review across cancer stages and treatment types addressing potential benefits and harms exists to date.To assess the effects of exercise on cancer-specific quality of life and adverse events in prostate cancer trials.We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, SPORTDiscus, and PEDro. We also searched grey literature databases, including trial registers. Searches were from database inception to March 2015. Standardised mean differences (SMDs) were calculated for meta-analysis.We included 16 randomised controlled trials (RCTs) involving 1574 men with prostate cancer. Follow-up varied from 8 wk to 12 mo. RCTs involved men with stage I-IV cancers. A high risk of bias was frequently due to problematic intervention adherence. Seven trials involving 912 men measured cancer-specific quality of life. Pooling of the data from these seven trials revealed no significant effect on this outcome (SMD 0.13, 95% confidence interval [CI] -0.08 to 0.34, median follow-up 12 wk). Sensitivity analysis of studies that were judged to be of high quality indicated a moderate positive effect estimate (SMD 0.33, 95% CI 0.08-0.58; median follow-up 12 wk). Similar beneficial effects were seen for cancer-specific fatigue, submaximal fitness, and lower body strength. We found no evidence of benefit for disease progression, cardiovascular health, or sexual function. There were no deaths attributable to exercise interventions. Other serious adverse events (eg, myocardial infarction) were equivalent to those seen in controls.These results support the hypothesis that exercise interventions improve cancer-specific quality of life, cancer-specific fatigue, submaximal fitness, and lower body strength.This review shows that exercise/physical activity interventions can improve quality of life, fatigue, fitness, and function for men with prostate cancer.
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