J Cave1, A Paschalis2, C Y Huang3, M West4, E Copson2, S Jack5, M P W Grocott5. 1. Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, MP 307, Tremona Road, Southampton, SO16 6YD, UK. Judith.cave@uhs.nhs.uk. 2. Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, MP 307, Tremona Road, Southampton, SO16 6YD, UK. 3. Department of Acute Internal Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK. 4. Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 5. Department of Critical Care Research, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Abstract
PURPOSE: Aerobic exercise improves prognosis and quality of life (QoL) following completion of chemotherapy. However, the safety and efficacy of aerobic exercise during chemotherapy is less certain. A systematic review was performed of randomised trials of adult patients undergoing chemotherapy, comparing an exercise intervention with standard care. METHOD: From 253 abstracts screened, 33 unique trials were appraised in accordance with PRISMA guidance, including 3257 patients. Interventions included walking, jogging or cycling, and 23 were of moderate intensity (50-80% maximum heart rate). RESULTS: Aerobic exercise improved, or at least maintained fitness during chemotherapy. Moderately intense exercise, up to 70-80% of maximum heart rate, was safe. Any reported adverse effects of exercise were mild and self-limiting, but reporting was inconsistent. Adherence was good (median 72%). Exercise improved QoL and physical functioning, with earlier return to work. Two out of four studies reported improved chemotherapy completion rates. Four out of six studies reported reduced chemotherapy toxicity. There was no evidence that exercise reduced myelosuppression or improved response rate or survival. CONCLUSIONS: 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.
PURPOSE: Aerobic exercise improves prognosis and quality of life (QoL) following completion of chemotherapy. However, the safety and efficacy of aerobic exercise during chemotherapy is less certain. A systematic review was performed of randomised trials of adult patients undergoing chemotherapy, comparing an exercise intervention with standard care. METHOD: From 253 abstracts screened, 33 unique trials were appraised in accordance with PRISMA guidance, including 3257 patients. Interventions included walking, jogging or cycling, and 23 were of moderate intensity (50-80% maximum heart rate). RESULTS: Aerobic exercise improved, or at least maintained fitness during chemotherapy. Moderately intense exercise, up to 70-80% of maximum heart rate, was safe. Any reported adverse effects of exercise were mild and self-limiting, but reporting was inconsistent. Adherence was good (median 72%). Exercise improved QoL and physical functioning, with earlier return to work. Two out of four studies reported improved chemotherapy completion rates. Four out of six studies reported reduced chemotherapy toxicity. There was no evidence that exercise reduced myelosuppression or improved response rate or survival. CONCLUSIONS: 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.
Authors: Victoria Mock; Constantine Frangakis; Nancy E Davidson; Mary E Ropka; Mary Pickett; Barbara Poniatowski; Kerry J Stewart; Lane Cameron; Kristin Zawacki; Laura J Podewils; Gary Cohen; Ruth McCorkle Journal: Psychooncology Date: 2005-06 Impact factor: 3.894
Authors: V Mock; M B Burke; P Sheehan; E M Creaton; M L Winningham; S McKenney-Tedder; L P Schwager; M Liebman Journal: Oncol Nurs Forum Date: 1994-06 Impact factor: 2.172
Authors: Elizabeth Ann Coleman; Julia A Goodwin; Robert Kennedy; Sharon K Coon; Kathy Richards; Carol Enderlin; Carol B Stewart; Paula McNatt; Kim Lockhart; Elias J Anaissie Journal: Oncol Nurs Forum Date: 2012-09 Impact factor: 2.172
Authors: Noémie Travier; Miranda J Velthuis; Charlotte N Steins Bisschop; Bram van den Buijs; Evelyn M Monninkhof; Frank Backx; Maartje Los; Frans Erdkamp; Haiko J Bloemendal; Carla Rodenhuis; Marnix A J de Roos; Marlies Verhaar; Daan ten Bokkel Huinink; Elsken van der Wall; Petra H M Peeters; Anne M May Journal: BMC Med Date: 2015-06-08 Impact factor: 8.775
Authors: Catherine Seet-Lee; Jasmine Yee; Heidi Morahan; Lois S Ross; Kate M Edwards Journal: Support Care Cancer Date: 2022-06-02 Impact factor: 3.603
Authors: Sophie K Allen; Vanessa Brown; Daniel White; David King; Julie Hunt; Joe Wainwright; Annabelle Emery; Emily Hodge; Aga Kehinde; Pradeep Prabhu; Timothy A Rockall; Shaun R Preston; Javed Sultan Journal: Ann Surg Oncol Date: 2021-11-01 Impact factor: 5.344
Authors: Michelle Harvie; Mary Pegington; Sacha J Howell; Nigel Bundred; Phil Foden; Judith Adams; Lee Graves; Alastair Greystoke; Mark P Mattson; Roy G Cutler; Julie Williamson; Karen Livingstone; Debbie McMullen; Katharine Sellers; Cheryl Lombardelli; Grace Cooper; Sarah McDiarmid; Anthony Howell Journal: Br J Cancer Date: 2021-12-15 Impact factor: 9.075
Authors: Linda Bühl; Thomas Abel; Florian Wolf; Max Oberste; Wilhelm Bloch; Michael Hallek; Thomas Elter; Philipp Zimmer Journal: Integr Cancer Ther Date: 2019 Jan-Dec Impact factor: 3.279
Authors: Cynthia C Forbes; Flavia Swan; Sarah L Greenley; Michael Lind; Miriam J Johnson Journal: J Cancer Surviv Date: 2020-04-24 Impact factor: 4.442
Authors: Hao Luo; Daniel A Galvão; Robert U Newton; Ciaran M Fairman; Dennis R Taaffe Journal: Integr Cancer Ther Date: 2019 Jan-Dec Impact factor: 3.279