Structured Exercise after Adjuvant Chemotherapy for Colon Cancer

作者：Kerry S. Courneya, Janette L. Vardy, Christopher J. O’Callaghan, Sharlene Gill, Christine M. Friedenreich, Rebecca Wong, Haryana M. Dhillon, Victoria Coyle, Neil Chua, Derek J. Jonker, Philip Beale, Kamal Haider, Patricia A. Tang, Tony Bonaventura, Ralph Wong, Howard J. Lim, Matthew Burge, Stacey Hubay, Michael Sanatani, Kristin L. Campbell, Fernanda Z. Arthuso, Jane Turner, Ralph M. Meyer, Michael Brundage, Patti O’Brien, Dongsheng Tu, Christopher M. Booth · 发表于：New England Journal of Medicine · 年份：2025 · DOI：10.1056/nejmoa2502760 · 被引用次数：340 · 研究领域：Cancer survivorship and care、Nutrition and Health in Aging、Colorectal Cancer Surgical Treatments

BACKGROUND: Preclinical and observational studies suggest that exercise may improve cancer outcomes. However, definitive level 1 evidence is lacking. METHODS: In this phase 3, randomized trial conducted at 55 centers, we assigned patients with resected colon cancer who had completed adjuvant chemotherapy to participate in a structured exercise program (exercise group) or to receive health-education materials alone (health-education group) over a 3-year period. The primary end point was disease-free survival. RESULTS: From 2009 through 2024, a total of 889 patients underwent randomization to the exercise group (445 patients) or the health-education group (444 patients). At a median follow-up of 7.9 years, disease-free survival was significantly longer in the exercise group than in the health-education group (hazard ratio for disease recurrence, new primary cancer, or death, 0.72; 95% confidence interval [CI], 0.55 to 0.94; P = 0.02). The 5-year disease-free survival was 80.3% in the exercise group and 73.9% in the health-education group (difference, 6.4 percentage points; 95% CI, 0.6 to 12.2). Results support longer overall survival in the exercise group than in the health-education group (hazard ratio for death, 0.63; 95% CI, 0.43 to 0.94). The 8-year overall survival was 90.3% in the exercise group and 83.2% in the health-education group (difference, 7.1 percentage points; 95% CI, 1.8 to 12.3). Musculoskeletal adverse events occurred more often in the exercise group than in ...