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Exercise intervention in people with cancer undergoing neoadjuvant cancer treatment and surgery: a systematic review

Exercise intervention in people with cancer undergoing neoadjuvant cancer treatment and surgery: a systematic review
Exercise intervention in people with cancer undergoing neoadjuvant cancer treatment and surgery: a systematic review
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.
cancer, oncology, neoadjuvant cancer treatment, exercise intervention, surgery
0748-7983
28-38
Loughney, L.
9c3e7db1-468b-405c-b32f-cedd9cc251fe
West, M.A.
98b67e58-9875-4133-b236-8a10a0a12c04
Kemp, G.J.
8732e1d2-a7c0-45a3-b69b-7649b517cd5f
Grocott, M.P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Jack, S.
d824ec2e-e92f-4e68-8fa5-953dfec46208
Loughney, L.
9c3e7db1-468b-405c-b32f-cedd9cc251fe
West, M.A.
98b67e58-9875-4133-b236-8a10a0a12c04
Kemp, G.J.
8732e1d2-a7c0-45a3-b69b-7649b517cd5f
Grocott, M.P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Jack, S.
d824ec2e-e92f-4e68-8fa5-953dfec46208

Loughney, L., West, M.A., Kemp, G.J., Grocott, M.P.W. and Jack, S. (2016) Exercise intervention in people with cancer undergoing neoadjuvant cancer treatment and surgery: a systematic review. European Journal of Surgical Oncology, 42 (1), 28-38. (doi:10.1016/j.ejso.2015.09.027). (PMID:26506862)

Record type: Article

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.

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Neoadjuvant SR_Final draft_LL_16_01_2015 - Accepted Manuscript
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More information

Accepted/In Press date: 30 September 2015
e-pub ahead of print date: 23 October 2015
Published date: January 2016
Keywords: cancer, oncology, neoadjuvant cancer treatment, exercise intervention, surgery
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 389811
URI: http://eprints.soton.ac.uk/id/eprint/389811
ISSN: 0748-7983
PURE UUID: b8de9278-0db2-46aa-848e-917c5be8447d
ORCID for M.A. West: ORCID iD orcid.org/0000-0002-0345-5356
ORCID for M.P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 15 Mar 2016 16:40
Last modified: 15 Mar 2024 03:58

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Contributors

Author: L. Loughney
Author: M.A. West ORCID iD
Author: G.J. Kemp
Author: M.P.W. Grocott ORCID iD
Author: S. Jack

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