Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy.
Department of Clinical Medicine and Surgery, Federico II University, 80131 Napoli, Italy.
Nutrients. 2020 Dec 31;13(1):136. doi: 10.3390/nu13010136.
Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status ( < 0.001), physical ( = 0.003), role ( = 0.002) and social functioning ( < 0.001), body image ( < 0.001), future perspective ( < 0.001), well-being ( = 0.001), and reductions in fatigue ( < 0.001), nausea and vomiting ( = 0.015), dyspnea ( = 0.001), constipation ( = 0.049), financial problems ( = 0.012), sexual functioning ( = 0.025), systematic therapy side effects ( < 0.001) and breast symptoms ( = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status ( = 0.048) and between serum 25(OH)D levels and breast symptoms ( = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.
健康的生活方式与乳腺癌(BC)幸存者更好的健康相关生活质量(HRQoL)、有利的预后和更低的死亡率相关。我们通过经过验证的问卷评估了 227 名参与 DEDiCa 试验(地中海饮食、运动、维生素 D)的 BC 幸存者在 12 个月生活方式改变计划后的 HRQoL 变化:EQ-5D-3L、EORTC-QLQ-C30 和 EORTC QLQ-BR23。使用方差分析测试了基线变化。进行了多元回归分析以评估治疗对 HRQoL 的影响。观察到总体健康状况(<0.001)、身体(=0.003)、角色(=0.002)和社会功能(<0.001)、身体形象(<0.001)、未来展望(<0.001)、幸福感(=0.001)增加,以及疲劳(<0.001)、恶心和呕吐(=0.015)、呼吸困难(=0.001)、便秘(=0.049)、经济问题(=0.012)、性功能(=0.025)、系统治疗副作用(<0.001)和乳房症状(=0.004)减少。多元回归分析发现 BMI 变化与总体健康状况(=0.048)之间以及血清 25(OH)D 水平与乳房症状(=0.002)之间存在负相关。传统地中海饮食和运动的健康生活方式治疗可能通过减轻体重对 BC 幸存者的 HRQoL 产生积极影响,而维生素 D 充足可能改善与 BC 相关的症状。这些发现与 HRQoL 较低的 BC 幸存者相关,因为他们的 HRQoL 较低会对治疗依从性和疾病结果产生负面影响。