在胰腺和非小细胞肺癌 (NEXTAC-TWO) 患者中进行营养和运动治疗的随机试验
Shuichi Mitsunaga1,2, Tateaki Naito3, Hisao Imai4,5
1Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Journal of cachexia, sarcopenia and muscle
|June 16, 2025
概括
晚期癌症的营养和运动治疗 (NEXTAC) 计划显示了良好的患者遵从性,但与单独观察相比,未能显著延长晚期癌症老年患者的无残疾生存期.
科学领域:
- 老年瘤学 老年瘤学
- 癌症康复 癌症康复
- 临床营养学 临床营养学
背景情况:
- 之前的研究 (NEXTAC-ONE) 表明,NEXTAC 计划可以预防老年癌症患者的低肌肉质量相关残疾.
- NEXTAC计划包括在家进行炼,分支链氨基酸补充剂和营养咨询.
研究的目的:
- 为了确定NEXTAC计划是否会延长晚期胰腺癌或非小细胞肺癌的老年患者的无残疾生存期.
- 在晚期癌症患者群体中评估综合营养和运动干预措施的有效性.
主要方法:
- 开放式,多中心,随机的II期试验,涉及131名老年患者 (≥70岁) 患有晚期胰腺癌或非小细胞肺癌,正在接受化疗.
- 患者被随机分配 (1:1) 接受NEXTAC计划或观察12周.
- 主要终点:无残疾生存率 (需要照顾的时间或死亡).
主要成果:
- 在NEXTAC手臂 (478天) 和对照手臂 (499天) 之间的中位数无残疾生存时间没有显著差异 (p=0.884).
- 在NEXTAC手臂中,无残疾生存的危险比为0.970 (95% CI 0.642-1.465).
- 在二次终点 (包括体重,肌肉质量,体力活动和营养状况) 中没有发现显著差异.
结论:
- 12周的NEXTAC计划显示了良好的患者服从,但与单独观察相比,没有显著改善无残疾生存率.
- 需要进一步的研究来调查NEXTAC计划对癌症患者低肌肉质量的进展的影响.
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