L Loughney1, M A West2, G J Kemp3, M P W Grocott4, S Jack4. 1. Anaesthesia and Critical Care Research Area, NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK. Electronic address: lisa.loughney@gmail.com. 2. Anaesthesia and Critical Care Research Area, NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK; Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Tremona Road, Southampton, SO16 6YD, UK. 3. Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK; Department of Musculoskeletal Biology and MRC - Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK. 4. Anaesthesia and Critical Care Research Area, NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, CE93, MP24, Tremona Road, Southampton, SO16 6YD, UK.
Abstract
BACKGROUND: Neoadjuvant cancer treatment decreases physical fitness. Low levels of physical fitness are associated with poor surgical outcome. Exercise training can stimulate skeletal muscle adaptations, such as increased mitochondrial content and improved oxygen uptake capacity that may contribute to improving physical fitness. This systematic review evaluates the evidence in support of exercise training in people with cancer undergoing the "dual hit" of neoadjuvant cancer treatment and surgery. METHODS: We conducted a systematic database search of Embase Ovid, Ovid Medline without Revisions, SPORTDiscus, Web of Science, Cochrane Central Register of Controlled Trials Library and ClinicalTrials.gov to identify trials addressing the effect of exercise training in people scheduled for neoadjuvant cancer treatment and surgery. Data extraction and analysis were based on a pre-defined plan. RESULTS: The database search yielded 6489 candidate abstracts. Ninety-four references included the required terms. Four studies were eligible for inclusion (breast cancer, locally advanced rectal cancer). All studies reported that exercise training was safe and feasible and that adherence rates were acceptable (66-96%). In-hospital exercise training improves physical fitness however the impact on HRQoL and other clinical important outcomes was uncertain. CONCLUSION: This is the first systematic review of the effects of exercise training in people scheduled for "dual-hit" treatment. This evidence synthesis indicates that this approach is safe and feasible but that there are insufficient controlled trials in this area to draw reliable conclusions about the efficacy of such an intervention, the optimal characteristics of the intervention, or the impact on clinical or patient reported outcomes.
BACKGROUND:Neoadjuvant cancer treatment decreases physical fitness. Low levels of physical fitness are associated with poor surgical outcome. Exercise training can stimulate skeletal muscle adaptations, such as increased mitochondrial content and improved oxygen uptake capacity that may contribute to improving physical fitness. This systematic review evaluates the evidence in support of exercise training in people with cancer undergoing the "dual hit" of neoadjuvant cancer treatment and surgery. METHODS: We conducted a systematic database search of Embase Ovid, Ovid Medline without Revisions, SPORTDiscus, Web of Science, Cochrane Central Register of Controlled Trials Library and ClinicalTrials.gov to identify trials addressing the effect of exercise training in people scheduled for neoadjuvant cancer treatment and surgery. Data extraction and analysis were based on a pre-defined plan. RESULTS: The database search yielded 6489 candidate abstracts. Ninety-four references included the required terms. Four studies were eligible for inclusion (breast cancer, locally advanced rectal cancer). All studies reported that exercise training was safe and feasible and that adherence rates were acceptable (66-96%). In-hospital exercise training improves physical fitness however the impact on HRQoL and other clinical important outcomes was uncertain. CONCLUSION: This is the first systematic review of the effects of exercise training in people scheduled for "dual-hit" treatment. This evidence synthesis indicates that this approach is safe and feasible but that there are insufficient controlled trials in this area to draw reliable conclusions about the efficacy of such an intervention, the optimal characteristics of the intervention, or the impact on clinical or patient reported outcomes.
Authors: An Ngo-Huang; Nathan H Parker; Xuemei Wang; Maria Q B Petzel; David Fogelman; Keri L Schadler; Eduardo Bruera; Jason B Fleming; Jeffrey E Lee; Matthew H G Katz Journal: Langenbecks Arch Surg Date: 2017-07-15 Impact factor: 3.445
Authors: Ryan J Marker; Emily Cox-Martin; Catherine M Jankowski; W Thomas Purcell; John C Peters Journal: Support Care Cancer Date: 2017-12-21 Impact factor: 3.603
Authors: Lawson Eng; Dan Pringle; Jie Su; XiaoWei Shen; Mary Mahler; Chongya Niu; Rebecca Charow; Kyoko Tiessen; Christine Lam; Oleksandr Halytskyy; Hiten Naik; Henrique Hon; Margaret Irwin; Vivien Pat; Christina Gonos; Catherine Chan; Jodie Villeneuve; Luke Harland; Ravi M Shani; M Catherine Brown; Peter Selby; Doris Howell; Wei Xu; Geoffrey Liu; Shabbir M H Alibhai; Jennifer M Jones Journal: Support Care Cancer Date: 2018-05-29 Impact factor: 3.603
Authors: Nathan H Parker; An Ngo-Huang; Rebecca E Lee; Daniel P O'Connor; Karen M Basen-Engquist; Maria Q B Petzel; Xuemei Wang; Lianchun Xiao; David R Fogelman; Keri L Schadler; Richard J Simpson; Jason B Fleming; Jeffrey E Lee; Gauri R Varadhachary; Sunil K Sahai; Matthew H G Katz Journal: Support Care Cancer Date: 2018-10-17 Impact factor: 3.603
Authors: Lene Thorsen; Camilla Kirkegaard; Jon Håvard Loge; Cecilie E Kiserud; Merethe Lia Johansen; Gunhild M Gjerset; Elisabeth Edvardsen; Hanne Hamre; Tone Ikdahl; Sophie D Fosså Journal: BMC Res Notes Date: 2017-06-15