Exercise therapy is an effective adjunctive strategy that improves cardiorespiratory fitness (CRF) among patients with adult-onset cancer, according to a study published in the Journal of Clinical Oncology.1
CRF decline — a commonly observed adverse event (AE) with locoregional or systemic anticancer therapies and their secondary effects — has been associated with increased symptom burden and morbidity among this patient population. Exercise therapy is thought to improve peak oxygen consumption (VO2peak) — a measure of CRF — and improve clinical outcomes, but findings from previous studies have been inconclusive.
For this study, researchers performed a systematic search and identified 48 randomized clinical studies representing 3632 patients with cancer that assessed the effect of exercise therapy on non-exercise control groups. Patients received aerobic (endurance) therapy, resistance therapy, or a combination of both for at least 3 weeks. The mean standard deviation patient age was 55±7.5 years, and 68% of patients were women.
Results showed that patients assigned to exercise therapy had significant increases in CRF with plus-2.80 mL O2×kg−1×min−1 compared with patients in the control group with plus-0.2 mL O2×kg−1×min−1 (weighted mean differences, +2.13 mL O2×kg−1×min−1; 95% CI, 1.58-2.67; I2, 20.6; P < .001). Subgroup analyses revealed that treatment effect modifiers, such as exercise modality, schedule, length, supervision, intervention timing, and site of primary cancer did not significantly affect outcomes.
Of the 30 trials that monitored adverse events (AE), a total of 44 cases were reported. AEs were primarily non-serious, and included dizziness, chest pain, and muscle-related pain. Serious AEs included hip fractures and myocardial infarction.
The authors concluded that the “findings support the recommendation of exercise therapy to augment, mitigate decline, and/or recover impaired VO2peak in patients with cancer.”
- Scott JM, Zabor EC, Schwitzer E, et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: a systematic review and meta-analysis [published online June 12, 2018]. J Clin Oncol. doi: 10.1200/JCO.2017.77.5809