Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival

被引:132
作者
Cannioto, Rikki A. [1 ]
Hutson, Alan [2 ]
Dighe, Shruti [1 ]
McCann, William [1 ]
McCann, Susan E. [1 ]
Zirpoli, Gary R. [3 ]
Barlow, William [4 ]
Kelly, Kara M. [5 ]
DeNysschen, Carol A. [1 ,6 ]
Hershman, Dawn L. [7 ]
Unger, Joseph M. [4 ]
Moore, Halle C. F. [8 ]
Stewart, James A. [9 ]
Isaacs, Claudine [10 ]
Hobday, Timothy J. [11 ]
Salim, Muhammad [12 ]
Hortobagyi, Gabriel N. [13 ]
Gralow, Julie R. [14 ]
Albain, Kathy S. [15 ]
Budd, G. Thomas [8 ]
Ambrosone, Christine B. [1 ]
机构
[1] Roswell Pk Comprehens Canc Ctr, Dept Canc Prevent & Control, Elm & Carlton St, Buffalo, NY 14263 USA
[2] Roswell Pk Comprehens Canc Ctr, Dept Biostat & Bioinformat, Buffalo, NY 14263 USA
[3] Boston Univ, Slone Epidemiol Ctr, Boston, MA USA
[4] Fred Hutchinson Canc Res Ctr, SWOG Stat Ctr, Seattle, WA USA
[5] Roswell Pk Comprehens Canc Ctr, Dept Pediat Oncol, Buffalo, NY 14263 USA
[6] SUNY Buffalo, Hlth Nutr & Dietet, Buffalo, NY USA
[7] Columbia Univ, Dept Med, New York, NY USA
[8] Cleveland Clin, Dept Hematol & Oncol, Taussig Canc Inst, Cleveland, OH USA
[9] Baystate Med Ctr, Dept Hematol & Oncol, Springfield, MA USA
[10] Georgetown Univ, Fisher Ctr Hereditary Canc & Clin Genom Res, Washington, DC USA
[11] Mayo Clin, Dept Med Oncol, Canc Ctr, Rochester, MN USA
[12] Allan Blair Canc Ctr, Med Oncol, Regina, SK, Canada
[13] Univ Texas MD Anderson Canc Ctr, Dept Breast Med Oncol, Div Canc Med Clin, Houston, TX USA
[14] Seattle Canc Care Alliance, Breast Med Oncol, Seattle, WA USA
[15] Loyola Univ Chicago, Dept Med, Stritch Sch Med, Chicago, IL USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2021年 / 113卷 / 01期
关键词
DIETARY-SUPPLEMENT USE; CLINICAL-TRIAL; MORTALITY; DIAGNOSIS; WOMEN; METAANALYSIS; ASSOCIATION; HEALTH; RECURRENCE; POSTMENOPAUSAL;
D O I
10.1093/jnci/djaa046
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Although physical activity has been consistently associated with reduced breast cancer mortality, evidence is largely based on data collected at one occasion. We examined how pre- and postdiagnosis physical activity was associated with survival outcomes in high-risk breast cancer patients. Methods Included were 1340 patients enrolled in the Diet, Exercise, Lifestyle and Cancer Prognosis (DELCaP) Study, a prospective study of lifestyle and prognosis ancillary to a SWOG clinical trial (S0221). Activity before diagnosis, during treatment, and at 1- and 2-year intervals after enrollment was collected. Patients were categorized according to the Physical Activity Guidelines for Americans as meeting the minimum guidelines (yes/no) and incrementally as inactive, low active, moderately active (meeting the guidelines), or high active. Results In joint-exposure analyses, patients meeting the guidelines before and 1 year after diagnosis experienced statistically significant reductions in hazards of recurrence (hazard ratio [HR]=0.59, 95% confidence interval [CI] = 0.42 to 0.82) and mortality (HR=0.51, 95% CI = 0.34-0.77); associations were stronger at 2-year follow-up for recurrence (HR=0.45, 95% CI = 0.31 to 0.65) and mortality (HR=0.32, 95% CI = 0.19 to 0.52). In time-dependent analyses, factoring in activity from all time points, we observed striking associations with mortality for low- (HR = 0.41, 95% CI = 0.24 to 0.68), moderate- (HR = 0.42, 95% CI = 0.23 to 0.76), and high-active patients (HR=0.31, 95% CI = 0.18 to 0.53). Conclusions Meeting the minimum guidelines for physical activity both before diagnosis and after treatment appears to be associated with statistically significantly reduced hazards of recurrence and mortality among breast cancer patients. When considering activity from all time points, including during treatment, lower volumes of regular activity were associated with similar overall survival advantages as meeting and exceeding the guidelines.
引用
收藏
页码:54 / 63
页数:10
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