Bewegungstherapie bei nicht-heilbaren, fortgeschrittenen Krebserkrankungen

Zusammenfassung

Dank der Entwicklung neuer Chemotherapie-Protokolle und verbesserter zielgerichteter Therapiestrategien hat sich das Überleben von Patienten mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen deutlich verlängert. Durch die krankheitsbedingten Symptome und die zusätzlichen therapiebedingten Nebenwirkungen wird die Lebensqualität dieser Patienten aber deutlich eingeschränkt. Übersichtsarbeiten zeigen, dass auch Patienten mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen von angepasster Bewegungstherapie profitieren können. Es wurde eine Literaturrecherche mithilfe elektronischer Datenbanken (PubMed, MEDLINE, EMBASE, Cochrane Library) durchgeführt und eine Übersicht der randomisierten kontrollierten Studien (RCTs) zur Bewegungstherapie bei nicht-heilbaren, fortgeschrittenen Krebserkrankungen gegeben. Die dargestellten Studien zeigen, dass eine gezielte Bewegungstherapie bei Patienten mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen sicher und durchführbar ist und positive Effekte auf die Lebensqualität, auf krankheits- und therapiebedingte Symptome wie Fatigue, Dyspnoe und auf den körperlichen Funktionsstatus erzielen kann. Der Artikel beinhaltet außerdem einen Diskurs mit einem Praxisbezug zum Thema Knochenmetastasen.

Summary

Thanks to the development of new chemotherapy protocols and improved targeted treatment strategies, the survival of patients with incurable, advanced cancers has been significantly extended. However, the quality of life of these patients is significantly limited by the disease-related symptoms and the additional therapy-related side effects. Literature reviews show that patients with incurable, advanced cancers can also benefit from adapted exercise therapy. A literature search using electronic databases (PubMed, MEDLINE, EMBASE, Cochrane Library) was carried out and an overview of the randomized, controlled trials (RCTs) for exercise therapy with regard to incurable, advanced cancers was given. The studies show that targeted exercise therapy is safe and feasible in patients with incurable, advanced cancers and can achieve positive effects on quality of life, on disease- and therapy-related symptoms such as fatigue, dyspnea as well as physical functional status. The article also contains a discourse with a practical relevance on the subject of bone metastases.

Stichworte

Bewegungstherapie - fortgeschrittene Krebserkrankungen - Knochenmetastasen.

Key words

Exercise therapy - advanced cancers - bone metastases.

Publikationsverlauf

Eingereicht: 29. April 2022

Angenommen: 13. Mai 2022

Artikel online veröffentlicht:
10. Oktober 2022

• Literatur

• 1 Rainbird K, Perkins J, Sanson-Fisher R. et al. The needs of patients with advanced, incurable cancer. Br J Cancer 2009; 101: 759e764
• 2 Teunissen SC, Wesker W, Kruitwagen C. et al. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage 2007; 34: 94-104
• 3 Miriam Levinger ZSSM.. In Life and in death: the story of people living with metastatic cancer. J Social Work Pract 2018;
• 4 Johnsen AT, Petersen MA, Pedersen L. et al. Do advanced cancer patients in Denmark receive the help they need? A nationally representative survey of the need related to 12 frequent symptoms/problems. Psychooncology 2013; 22: 1724-1730
• 5 Berger AM, Mooney K, Alvarez-Perez A. et al. Cancer related fatigue, version 2. 2015. J Natl Compr Canc Netw 2015; 13: 1012-1039
• 6 Gerritsen JK, Vincent AJ.. Exercise improves quality of life in patients with cancer: a systematic review and metaanalysis of randomised controlled trials. Br J Sports Med 2016; 50: 796-803
• 7 Mishra SI, Scherer RW, Snyder C. et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 2012; 8: CD008465
• 8 Cormie P, Zopf EM, Zhang X. et al. The impact of exercise on cancer mortality, recurrence, and treatment related adverse effects. Epidemiol Rev 2017; 39: 71-92
• 9 Tomlinson D, Diorio C, Beyene J. et al. Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil 2014; 93: 675-686
• 10 Speck RM, Courneya KS, Masse LC. et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2010; 4: 87-100
• 11 Furmaniak AC, Menig M, Markes MH.. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2016; 9: CD005001
• 12 Jones LW. et al. Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer. J Clin Oncol 2016; 34: 2743-2749
• 13 Scott JM. et al. Exercise Therapy and Cardiovascular Toxicity in Cancer. Circulation 2018; 137: 1176-1191
• 14 Duregon F. et al. Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: A systematic review. Crit Rev Oncol Hematol 2018; 121: 90-100
• 15 Zimmer P. et al. Effects of Exercise Interventions and Physical Activity Behavior on Cancer Related Cognitive Impairments: A Systematic Review. Biomed Res Int 2016; 2016: 1820954
• 16 Campbell KL. et al. Review of exercise studies in breast cancer survivors: attention to principles of exercise training. Br J Sports Med 2012; 46: 909-916
• 17 Winters-Stone KM. et al. Influence of weight training on skeletal health of breast cancer survivors with or at risk for breast cancer-related lymphedema. J Cancer Surviv 2014; 8: 260-268
• 18 Campbell KL. et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 2019; 51: 2375-2390
• 19 Prue C, Morgan A, Lucy B. et al. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 2018; 209: 184-187
• 20 Van Blarigan EL, Fuchs CS, Niedzwiecki D. et al. Association of survival with adherence to the American Cancer.
• 21 Segal R, Zwaal C, Green E. et al. Exercise for people with cancer: a clinical practice guideline. Curr Oncol 2017; 24: 40-46
• 22 Eyigor S, Akdeniz S.. Is exercise ignored in palliative cancer patients?. World J Clin Oncol 2014; 5: 554-559
• 23 Frikkel J, Gotte M, Beckmann M. et al. Fatigue, barriers to physical activity and predictors for motivation to exercise in advanced Cancer patients. BMC Palliat Care 2020; 19: 43
• 24 Navigante A, Morgado PC.. Does physical exercise improve quality of life of advanced cancer patients? . Curr Opin Support Palliat Care 2016; 10: 306-309
• 25 Heywood R, McCarthy AL, Skinner TL.. Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review. Support Care Cancer 2017; 25: 3031-3050
• 26 Dittus KL, Gramling RE, Ades PA.. Exercise interventions for individuals with advanced cancer: a systematic review. Prev Med 2017; 104: 124-132
• 27 Nadler MB, Desnoyers A, Langelier DM. et al. The effect of exercise on quality of life, fatigue, physical function and safety in advanced solid tumor cancers: a meta-analysis of randomized control trials. J Pain Symptom Manage 2019; 19: S0885-S3924
• 28 Chen YaJi, Li Xx, Ma H. et al. Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2020; 59: 734-749.e10
• 29 Toohey K, Chapman M, Rushby AM. et al. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv 2022; 18 Online ahead of print
• 30 Adamsen L, Quist M, Andersen C. et al. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy randomized controlled trial. BMJ. 2009; 339: b3410
• 31 Brown P, Clark MM, Atherton P. et al. Will improvement in quality of life (QOL) impact fatigue in patients receiving radiation therapy for advanced cancer?. Am J Clin Oncol 2006; 29: 52-58
• 32 Cheville AL, Girardi J, Clark MM. et al. Therapeutic exercise during outpatient radiation therapy for advanced cancer: feasibility and impact on physical well-being. Am J Phys Med Rehabil 2010; 89: 611-619
• 33 Cheville AL, Kollasch J, Vandenberg J. et al. A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manage 2013; 45: 811-821
• 34 Cormie P, Newton RU, Spry N. et al. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 2013; 16: 328-335
• 35 Coleman EA, Coon S, Hall-Barrow J. et al. Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs 2003; 26: 410-419
• 36 Dhillon HM, Bell ML, van der Ploeg HP. et al. Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial. Ann Oncol Off J Eur Soc Med Oncol 2017; 28: 1889-1897
• 37 Galvao DA, Taaffe DR, Spry N. et al. Exercise preserves physical function in prostate cancer patients with bone metastases. Med Sci Sports Exerc 2018; 50: 393-399
• 38 Henke CC, Cabri J, Fricke L. et al. Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV. Support care cancer Off J Multinatl Assoc Support Care Cancer 2014; 22: 95-101
• 39 Hwang C-L, Yu C-J, Shih J-Y. et al. Effects of exercise training on exercise capacity in patients with non-small cell lung cancer receiving targeted therapy. Support care cancer Off J Multinatl Assoc Support Care Cancer 2012; 20: 3169-3177
• 40 Jastrzebski D, Maksymiak M, Kostorz S. et al. Pulmonary rehabilitation in advanced lung cancer patients during chemotherapy. Adv Exp Med Biol 2015; 861: 57-64
• 41 Ligibel JA, Giobbie-Hurder A, Shockro L. et al. Randomized trial of a physical activity intervention in women with metastatic breast cancer. Cancer 2016; 122: 1169-1177
• 42 Oldervoll LM, Loge JH, Lydersen S. et al. Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologist 2011; 16: 1649-1657
• 43 Poort H, Peters MEWJ, van der Graaf WTA. et al. Cognitive behavioral therapy or graded exercise therapy compared with usual care for severe fatigue in patients with advanced cancer during treatment a randomized controlled trial. Ann Oncol Off J Eur Soc Med Oncol 2020; 31: 115-122
• 44 Porter LS, Carson JW, Olsen M. et al. Feasibility of a mindful yoga program for women with metastatic breast cancer: results of a randomized pilot study. Support care cancer Off J Multinatl Assoc Support Care Cancer 2019; 27: 4307-4316
• 45 Pyszora A, Budzyński J, Wojcik A. et al. Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial. Support care cancer Off J Multinatl Assoc Support Care Cancer 2017; 25: 2899-2908
• 46 Quist M, Langer SW, Lillelund C. et al. Effects of an exercise intervention for patients with advanced inoperable lung cancer undergoing chemotherapy: a randomized clinical trial. Lung Cancer 2020; 145: 76-82
• 47 Rief H, Petersen LC, Omlor G. et al. The effect of resistance training during radiotherapy on spinal bone metastases in cancer patients – A randomized trial. Radiother Oncol 2014; 112: 133-139
• 48 Rutkowska A, Jastrzebski D, Rutkowski S. et al. Exercise training in patients with non-small cell lung cancer during in-hospital chemotherapy treatment: a randomized controlled triaL. J Cardiopulm Rehabil Prev 2019; 39: 127-133
• 49 Schuler MK, Hentschel L, Kisel W, Kramer M. et al. Impact of different exercise programs on severe fatigue in patients undergoing anticancer treatment randomized controlled trial. J Pain Symptom Manage 2017; 53: 57-66
• 50 Scott JM, Iyengar NM, Nilsen TS. et al. Feasibility, safety, and efficacy of aerobic training in pretreated patients with metastatic breast cancer: a randomized controlled trial. Cancer 2018; 124: 2552-2560
• 51 Solheim TS, Laird BJA, Balstad TR. et al. A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer. J Cachexia Sarcopenia Muscle 2017; 8: 778-788
• 52 Yee J, Davis GM, Hackett D. et al. Physical activity for symptom management in women with metastatic breast cancer: a randomized feasibility trial on physical activity and breast metastases. J Pain Symptom Manage 2019; 58: 929-939
• 53 De Lazzari N, Niels T, Tewes M. et al. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers (Basel) 2021; 13: 4478
• 54 Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 2006; 12: 6243s-6249s
• 55 Campbell K. et al. Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals. JCO Oncol Pract 2022; OP2100454
• 56 Rief H, Heinhold M, Bruckner T. et al. Quality of life, fatigue and local response of patients with unstable spinal bone metastases under radiation therapy-a prospective trial. Radiat Oncol Lond Engl 2014; 9: 133
• 57 Campbell KL, Weller S, Cormie P. et al. Enhancing safety of exercise for individuals with bone metastases: Screening recommendations developed through Delphi consensus process. J Clin Oncol. 2020 JCO.2020.38.15_suppl.e24042
• 58 Fourney DR, Frangou EM. et al. Spinal Instability Neoplastic Score: An Analysis of Reliability and Validity From the Spine Oncology Study Group. J Clin Oncol 2011; 29: 3072-3077
• 59 Taneichi H, Kaneda K, Takeda N. et al. Risk Factors and Probability of Vertebral Body Collapse in Metastases of the Thoracic and Lumbar Spine. Spine 1997; 22: 239-245
• 60 Mizumoto M, Harada H, Asakura H. et al. Prognostic factors and a scoring system for survival after radiotherapy for metastases to the spinal column: A review of 544 patients at Shizuoka Cancer Center Hospital. Cancer. 2008; 113: 2816-2822
• 61 Mirels H.. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clinical Orthopaedics and Related Research 1989; 249: 256-264
• 62 Mirels H.. The Classic: Metastatic Disease in Long Bones a Proposed Scoring System for Diagnosing Impending Pathologic Fractures”. Clinical Orthopaedics and Related Research 2003; 415: 4-13
• 63 Galvão DA, Taaffe TR, Cormie P. et al. Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial. BMC Cancer 2011; 11: 517
• 64 Sprave T, Rosenberger F, Verma V. et al. Paravertebral muscle training in patients with unstable spinal metastases receiving palliative radiotherapy: an exploratory randomized feasibility trial. Cancers (Basel) 2019; 11: 11