小児がん治療中の患児に対する身体活動介入の効果—メタ分析による知見の統合

The Effects of Including Physical Activity as an Intervention during the Treatment of Childhood Cancer: A Meta-Analysis

要旨

　目的：小児がん治療中の患児に対する身体活動介入の効果を，メタ分析によって検討した．

　方法：発行されているレビュー論文4編の内容検討，および2009年以降の文献検索の二段階で抽出した計823編のうち，採択基準をすべて満たした6編の文献をメタ分析の対象とした．解析方法は，各結果指標を概念化し，その概念の効果量（Hedges' g）および95％信頼区間（CI）を算出した．

　結果：小児がん患児に対する身体活動介入による各結果指標への影響は，QOL【g＝0.17, 95％CI＝−0.48 to 0.57】，がんに伴う倦怠感【g＝0.25, 95％CI＝−0.16 to 0.67】，ヘモグロビン値【g＝0.11, 95％CI＝−0.32 to 0.75】，睡眠【g＝0.22, 95％CI＝−0.32 to 0.47】，活動性【g＝0.14, 95％CI＝−0.95 to 1.23】，足関節可動域【g＝0.47, 95％CI＝−0.32 to 0.75】，体重【g＝0.16, 95％CI＝−0.76 to 1.07】およびBMI【g＝−0.12, 95％CI＝−1.04 to 0.80】であった．

　結論：小児がん患児に対する身体活動介入の効果は，対照群と比較して大差がなかった．本研究の対象文献数が少なく，介入内容や結果指標のばらつきの大きいことが介入効果に影響した可能性があり，今後は小児がん患児における身体活動の研究を集積していくことが必要である．

　Objective: Physical activity as an element of the treatment for patients with childhood cancer is important to improve patients' muscle strength and quality of life (QOL). However, the effects of including physical activity as part of the treatment for children with cancer are largely unclear. Hence, this study aimed to clarify the effects of physical activity as part of the intervention for patients with childhood cancer.

　Methods: First, we examined the contents of four relevant and published review studies. Next, a search was conducted on five databases to identify relevant studies. The search term revolved around the combination of key words such as “children” AND “cancer” OR “oncology” OR “leukemia” OR “lymphoma” OR “tumor” AND “physical activity” OR “exercise” OR “daily activity” OR “life activity”. Of the 823 studies found, we identified six studies that met all the criteria. Effect size (Hedges' g) regarding physical activity was estimated using a random effect model with 95% confidence intervals (CI).

　Results: In patients with childhood cancer, physical activity had an impact on QOL [g=0.17, 95%CI=-0.48 to 0.57], fatigue [g=0.25, 95%CI=-0.16 to 0.67], hemoglobin [g=0.11, 95%CI=-0.32 to 0.75], sleep quality [g=0.22, 95%CI=-0.32 to 0.47], activity [g=0.14, 95%CI=-0.95 to 1.23], ankle dorsiflexion active range of motion [g=0.47, 95%CI=-0.32 to 0.75], body mass [g=0.16, 95%CI=-0.76 to 1.07], and BMI [g=-0.12, 95%CI=-1.04 to 0.80].

　Conclusion: These results suggested that physical activity as part of the treatment regimen for children during the treatment of childhood cancer was not effect. For future studies, it is need to measure the effectiveness of physical activity during the treatment of childhood cancer.