Background

The natural history of physical activity levels during and following gynaecological cancer treatment is not well understood. This is required in order to establish the time at which physical activity levels are lowest in order to target cancer rehabilitation or exercise interventions in gynaecological cancer population accordingly.

Objectives

To conduct a systematic review to evaluate the impact of gynaecological cancer treatments on physical activity levels and to summarise the pattern of changes in physical activity levels over time among patients with gynaecological cancer.

Methods

A comprehensive literature search was performed via MEDLINE (1946–2018), CINAHL (1982–2018), EMBASE (1947–2018), Ovid Emcare (1947–2018), PsycINFO (1806–2018) and the Cochrane Library (1991–2018). Studies were eligible for inclusion if they had assessed changes in physical activity levels during and after gynaecological cancer treatment. The methodological quality of the eligible studies was assessed by two independent reviewers using the Joanna Briggs Institute Critical Appraisal Tools.

Results

In total, six studies (three cohort studies and three cross-sectional studies) with 1607 participants were included. All studies used patient-reported physical activity measures. Two of the three cohort studies measured patient-recalled physical activity levels before diagnosis (baseline), and length of follow-up varied across all studies. The majority of participants were treated surgically ± adjuvant therapy. Physical activity levels decreased at 6 months following surgery when compared with pre-treatment levels. Approximately 91% of participants did not meet physical activity guidelines 2 years following diagnosis, and 58% reported being less physically active 3 years after diagnosis, compared with the pre-diagnosis levels.

Conclusions

Despite the paucity of evidence and limitations in the current body of literature, this review demonstrated that compared to pre-diagnosis, levels of physical activity remain low in gynaecological cancer survivors up to 3 years after diagnosis. More research is warranted to better characterise the pattern of change of physical activity levels across the disease trajectory and identify changes in physical activity patterns by cancer treatments and gynaecological tumour streams in order to target interventions accordingly.

中文翻译：

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妇科癌症治疗对身体活动水平的影响：观察性研究的系统综述。

背景

妇科癌症治疗期间和之后的身体活动水平的自然史尚未得到很好的了解。这是必需的，以便确定最低的身体活动水平，以便针对癌症康复或相应地对妇科癌症人群进行干预。

目标

进行系统评价，以评估妇科癌症治疗对身体活动水平的影响，并总结妇科癌症患者随时间推移身体活动水平的变化模式。

方法

通过MEDLINE（1946-2018），CINAHL（1982-2018），EMBASE（1947-2018），Ovid Emcare（1947-2018），PsycINFO（1806-2018）和Cochrane图书馆（1991-2018）进行了全面的文献检索）。如果研究评估了妇科癌症治疗期间和之后身体活动水平的变化，则符合纳入条件。两名独立评审使用Joanna Briggs Institute关键评估工具对合格研究的方法学质量进行了评估。

结果

总共包括6项研究（三项队列研究和三项横断面研究），共有1607名参与者。所有研究均使用患者报告的体育锻炼量度。三项队列研究中的两项测量了患者在诊断之前的身体活动水平（基线），并且随访时间在所有研究中均不同。大多数参与者接受了手术±辅助治疗。与治疗前相比，术后6个月的体育活动水平下降。与诊断前的水平相比，诊断后2年中约有91％的参与者未达到体育锻炼准则，而诊断后3年中有58％的参与者报告其身体活动较少。

结论

尽管当前文献缺乏证据和局限性，但该评价表明，与预诊断相比，妇科癌症幸存者在诊断后长达3年的体育活动水平仍然很低。有必要进行更多的研究，以更好地表征整个疾病轨迹中身体活动水平的变化模式，并通过癌症治疗和妇科肿瘤流识别身体活动模式的变化，从而针对性地采取干预措施。