A systematic review of the safety and efficacy of aerobic exercise during cytotoxic chemotherapy treatment

Cave, Judith; Paschalis, Alec; Huang, Chenguang; West, Malcolm; Copson, ER; Jack, Sandy; Grocott, Michael P.W.

doi:10.1007/s00520-018-4295-x

Cited by 49 publications

(29 citation statements)

References 36 publications

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“…However, prehabilitation programs are also targeting non-surgical cancer patients receiving pharmacological treatment only, e.g., as chemotherapy and/or radiotherapy [15][16][17]. In this context, a recent meta-analysis on 3257 patients with cancer indicated that moderate aerobic exercise performed at 70-80% of maximum heart rate not only was feasible and safe but also showed beneficial effects in QoL and physical functioning and maintained or at least improved fitness during concomitant chemotherapy [18]. Although not without bearing a considerably risk of bias, pooled data from another recent metaanalysis revealed that prehabilitation significantly improved mood, physical well-being, and immune function for prostate cancer patients and improved fatigue and psychological outcomes with a trend indicating better QoL among breast cancer patients [19].…”

Section: Introductionmentioning

confidence: 99%

High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

Palma

Hasenoehrl

Jordakieva

et al. 2020

Support Care Cancer

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Purpose To evaluate the impact of high-intensity interval training (HIIT) on health-related outcome parameters in the prehabilitation of patients diagnosed with cancer. Methods A systematic review and meta-analysis of comparative studies on HIIT in cancer prehabilitation conducted by screening standard databases from their inception to March 30, 2020. Outcomes of interest included cardiorespiratory fitness, feasibility, safety, clinical, and patient-reported outcomes. Results Of the 855 identified studies, 8 articles met the inclusion criteria (7 randomized, 1 non-randomized controlled trial) with a total of 896 patients. The study protocols were heterogeneous, but the methodological quality ranged from good to high according to PEDro scale. Meta-analysis revealed a significant improvement of peak oxygen consumption (VO2peak) achieved with HIIT compared to usual care. Furthermore, HIIT was feasible and safe, showing low risk of adverse events and positive effects on health-related outcomes in prehabilitative settings. Conclusion In the phase of prehabilitation, HIIT has potential health benefits in patients diagnosed with cancer and is feasible and safe to perform. Nonetheless, larger randomized controlled trials focusing on long-term effects (such as cancer recurrence or survival rates) are missing, to underline the potential relevance of HIIT for cancer patients.

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Section: Introductionmentioning

confidence: 99%

High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

Palma

Hasenoehrl

Jordakieva

et al. 2020

Support Care Cancer

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“…Physical activity (PA) benefits people living with or beyond cancer by improving physical function and QoL during and after cancer treatment, and cancer-related outcomes like treatment completion, maintenance of, or faster return to, pretreatment health, fewer unnecessary healthcare visits and better survival rates [6,[17][18][19][20][21][22]. Improvements are greater in those engaging in PA sooner after a diagnosis [23].…”

Section: Introductionmentioning

confidence: 99%

Physical activity and nutrition interventions for older adults with cancer: a systematic review

et al. 2020

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The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations.

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“…The effects of physical training in cancer patients may vary depending on tumor type, stage and exercise modalities. A systematic review analyzing the effectiveness of aerobic exercise during chemotherapy treatment in cancer patients, has shown beneficial effects in terms of both quality of life and muscle function [37] . In chemotherapy-treated breast cancer patients, exercise increases muscle fiber cross-sectional area, citrate synthase activity, mitochondrial complex protein levels and muscle capillarization [38] .…”

Section: Exercise As a Modulator Of Muscle Metabolismmentioning

confidence: 99%

Muscle mitochondria and oxidative metabolism as targets against cancer cachexia

Ballarò¹,

Penna²,

Ferraro³

et al. 2019

JCMT

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Cancer cachexia is a debilitating syndrome mainly characterized by muscle and fat wasting, leading to the progressive loss of body weight and complicating the management of cancer patient. In particular, the loss of muscle weight is a negative prognostic factor, being associated with chemotherapy toxicity and reduced survival. Increased inflammation and protein dysmetabolism are some of the impairments that lead to muscle wasting in cancer patients. Together with these alterations, tumor growth and chemotherapy administration may affect mitochondrial function, impinging on the muscle energy metabolism. Indeed, therapeutic approaches poised to correct both hypercatabolism and mitochondrial alterations could be effective in preventing cancer-induced muscle wasting. Among the non-pharmacological approaches, exercise training is one of the best modulator of muscle physiology able to impinge on both protein and energy metabolism. However, the wasting phenotype that characterizes cancer patients could be not compatible with physical training, prompting the development of different strategies to improve muscle metabolism. The aim of this mini-review is to discuss both the beneficial effects and the limitations of exercise training in cancer cachexia and the adoption of drugs able to modulate exercise-induced pathways.

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A systematic review of the safety and efficacy of aerobic exercise during cytotoxic chemotherapy treatment

Abstract: Exercise during chemotherapy is safe and should be encouraged because of beneficial effects on QoL and physical functioning. More research is required to determine the impact on chemotherapy completion rates and prognosis.

Cited by 49 publications

References 36 publications

High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

Physical activity and nutrition interventions for older adults with cancer: a systematic review

Muscle mitochondria and oxidative metabolism as targets against cancer cachexia

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