Background

High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have been increasingly adopted for localized prostate cancer (PCa) under active surveillance (AS). However, it is unclear which training modality is the most favorable in terms of cardiorespiratory fitness and biochemical progression.

Methods

We searched PubMed, Cochrane and Embase for relevant RCTs. PRISMA guideline was adopted to ensure optimal conduct of this study. Serum prostate specific antigen (PSA) and peak VO2 were selected as primary outcomes and PSA doubling time (PSADT) and testosterone were selected as secondary outcomes. Only articles written in English were included. Cochrane risk-of-bias tool was used for risk of bias evaluation.

Results

A total of 501 studies were selected. Six RCTs with 222 patients were included for data extraction and analysis. High-intensity interval training (HIIT) group demonstrated significantly lower PSA compared with usual care (UC) (MD = −1.4; 95%CI = −2.77 to −0.03) and moderate-intensity continuous training (MICT) group (MD = −1.67; 95%CI = −3.30 to −0.05). Both HIIT and MICT showed significantly improved peak VO₂ compared with UC. No significant difference was observed in PSADT and testosterone among different training modalities and UC. Regarding peak VO₂, MICT had the highest surface under cumulative ranking curve (SUCRA) scores (98.1%). For serum PSA, HIIT had the highest probability (97.8%) to be the training with the highest efficacy. The potential source of bias mainly came from poorly performed allocation concealment and blinding strategies.

Conclusions

The present study indicated that HIIT and MICT showed considerable cardiorespiratory benefits for localized PCa. HIIT was preferred over MICT in biochemical progression control in terms of decreasing serum PSA levels. However, MICT was favored over HIIT regarding cardiorespiratory benefits. The findings of this study may facilitate future lifestyle intervention, particularly in the form of physical training, for individuals diagnosed with localized PCa under AS.

中文翻译：

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主动监测下局部前列腺癌的高强度间歇训练与中等强度持续训练：系统评价和网络荟萃分析

背景

高强度间歇训练（HIIT）和中等强度持续训练（MICT）已越来越多地用于主动监测（AS）下的局限性前列腺癌（PCa）。然而，就心肺健康和生化进展而言，尚不清楚哪种训练方式最有利。

方法

我们检索了 PubMed、Cochrane 和 Embase 的相关随机对照试验。采用 PRISMA 指南以确保本研究的最佳进行。选择血清前列腺特异性抗原（PSA）和峰值摄氧量作为主要结果，选择PSA倍增时间（PSADT）和睾酮作为次要结果。仅包含用英文撰写的文章。 Cochrane 偏倚风险工具用于偏倚风险评估。

结果

总共选择了 501 项研究。纳入 6 项随机对照试验，涉及 222 名患者，用于数据提取和分析。与常规护理（UC）（MD = -1.4；95%CI = -2.77至-0.03）和中等强度持续训练（MICT）组（MD = -）相比，高强度间歇训练（HIIT）组的PSA显着降低1.67；95%CI = -3.30 至 -0.05）。与 UC 相比，HIIT 和 MICT 均显示出峰值 VO ₂显着改善。不同训练方式和 UC 之间 PSADT 和睾酮没有显着差异。关于峰值VO ₂，​​MICT具有最高的累积排名曲线下表面(SUCRA)分数(98.1%)。对于血清PSA，HIIT最有可能（97.8%）成为效果最好的训练。潜在的偏差来源主要来自执行不佳的分配隐藏和盲法策略。

结论

目前的研究表明，HIIT 和 MICT 对局部前列腺癌显示出相当大的心肺益处。在降低血清 PSA 水平方面，HIIT 在生化进展控制方面优于 MICT。然而，就心肺功能而言，MICT 比 HIIT 更受青睐。这项研究的结果可能有助于未来的生活方式干预，特别是对于诊断为 AS 下局部 PCa 的个体进行体能训练的形式。