Ariketa fisikoa eta linfomadun paziente onkogeriatrikoak: ausazko eta kontrolatutako entsegu kliniko baten datu preliminarrak

Abstract

[EU]

Aurrekariak: Minbizia adineko pertsonen gaixotasuna dela esan daiteke (neoplasia gaizto guztien %65ek baino gehiagok eragiten diote populazio horri), oso ohikoa delarik adin aurreratuko paziente hemato-onkologikoak aurkitzea. Hainbat saiakuntza klinikok ariketa fisikoak gaixo onkologikoetan dituen onurak erakutsi dituzten arren, azterketa gehienetatik kanpo geratu ohi dira adineko pazienteak, emaitza horiek populazio horretara estrapolatu ezin direlarik. Arazo horri aurre eginez, esklusiboki 70 urtetik gorako eta tratamendu sistemikoa jasotzen ari diren linfomadun pazienteak jarduera fisikoko (JF) esku-hartze presentzial eta gainbegiratu bat egiteko lagin gisa erabiltzen dituen orain arteko lehenengo entsegua da ONKO-FRAIL. Helburuak: 70 urtetik gorako linfomadun pazienteen tratamendu sistemikoa hasi aurretiko balorazioan aldagai psikoafektibo, bizi-kalitatezko, akidurazko eta fisiko desberdinen arteko asoziazioak ezagutzea eta JFko interbentzio indibidualizatu batek alor horietan eraginik duen ezagutzea dira ikerketa honen helburuak. Metodoak: Ausazko saiakuntza kliniko kontrolatu eta multizentrikoa burutu zen lehen lerroko tratamendu sistemikorako hautagaiak ziren, ≥70 urte, linfoma diagnostikoa eta ECOG ≤2 zuten pazienteetan: kontrol-taldeak ohiko zainketak jaso zituen eta esku-hartze taldeak JFko 12 asteko programa presentzial eta indibidualizatua burutu zuen. Emaitzak: 17 parte-hartzaile aztertu ziren (bataz besteko adina 78,18, emakumeak %64,70), oinarrizko egoera onekoak (Gijón: 17, Barthel: 98,24, Lawton: 7,76). Depresio-maila handiagoak (Yesavage aldagaia) MNA-SF, EORTC QLQ-C30, SPPB, SRT, EORTC QLQ-FA12 eta 8ft-TUGT aldagaien emaitza okerragoekin esanguratsuki (p <0,05) harremandu ziren. Bizi-kalitate (EORTC QLQ-C30) hobeak asoziazo esanguratsuak (p <0,05) erakutsi zituen MNA-SF, SRT eta EORTC QLQ-FA12 emaitza hobeekin. Akidura (EORT QLQ-FA12) SPPB, SRT eta 8ft-TUGT kaskarragoekin asoziatu zen esanguratsuki (p <0,05). V1 eta V2 balorazio aldiak alderatzean, ez zen esku-hartzearen eragin esanguratsurik ikusi ez aldagaietan eta ezta taldeen artean ere. Ondorioak: Aldagai psikoafektibo, bizi-kalitatezko, akidurazko eta fisiko desberdinen arteko asoziazio esanguratsuak ikusi dira. Esku-hartzearekin bizi-kalitate eta akidura-mailaren beherakada txikiagoa jasateko joera bistaratu den arren, ikerketa gehiago, lagin handiagokoak eta jarraipen luzeagokoak behar dira JFko programa batek linfomadun adineko paziente tratamendu sistemikoan zehar laguntzen dien baieztatzeko.

[EN]

Background: Cancer can be described as a disease of the elderly (more than 65% of all malignant neoplasms affect this population) and it is increasingly common to find hemato-oncological patients of advanced age. Although several clinical trials have shown the benefits of physical activity in oncological patients, elder patients are often excluded from most studies, and these results cannot be extrapolated to such population. Tackling this issue, ONKO-FRAIL is the first study to date that includes lymphoma patients over 70 years who are currently undergoing systemic treatment as sample for a face-to-face, supervised and multicomponent physical exercise intervention (PE). Purpose: The objectives of this study were to evaluate associations among different basal psychoaffective, quality of life, fatigue and physical variables’ scores that were assessed before receiving the systemic treatment in patients with lymphoma who are ≥70-years-old and to study whether an individualized PE intervention has any effects in those areas. Methods: A controlled and multicentric randomized clinical trial was conducted in patients with lymphoma who were ≥70-years-old, with ECOG ≤2 and those who were eligible for front-line systemic treatment. The control group received routine care while the intervention group conducted a 12-week PE individualized face-to-face program. Results: 17 participants (mean age 78.18, 64.70% women) in good baseline conditions (Gijón: 17, Barthel: 98.24, Lawton: 7.76) were analyzed. Higher depression levels (Yesavage variable) were significantly associated (p <0.05) with worse MNA-SF, EORTC QLQ-C30, SPPB, SRT, EORTC QLQ-FA12 and 8ft-TUGT variables’ scores. Better quality of life (EORTC QLQ-C30) showed significant associations (p <0.05) with better MNA-SF, SRT and EORTC QLQ-FA12 scores. Higher fatigue levels (EORT QLQ-FA12) were significantly associated (p <0.05) with worse SPPB, SRT and 8ft-TUGT results. When comparing the V1 and V2 assessment periods, no significant impact of the intervention was observed neither on any variable nor between groups. Conclusions: Significant associations among psychoaffective, quality of life, fatigue and physical variables have been observed. Although a tendency to a lower decline in quality of life and fatigue levels has been shown in the intervention group, further studies with more follow-up and a larger sample size are needed to confirm whether a PE program is helpful in elderly lymphoma patients during systemic treatment.