Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: A systematic review and meta-analysis Journal Article


Authors: Scott, J. M.; Zabor, E. C.; Schwitzer, E.; Koelwyn, G. J.; Adams, S. C.; Nilsen, T. S.; Moskowitz, C. S.; Matsoukas, K.; Iyengar, N. M.; Dang, C. T.; Jones, L. W.
Article Title: Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: A systematic review and meta-analysis
Abstract: Purpose To evaluate the effects of exercise therapy on cardiorespiratory fitness (CRF) in randomized controlled trials (RCTs) among patients with adult-onset cancer. Secondary objectives were to evaluate treatment effect modifiers, safety, and fidelity. Methods A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library was conducted to identify RCTs that compared exercise therapy to a nonexercise control group. The primary end point was change in CRF as evaluated by peak oxygen consumption (VO2peak; in mL O2 3 kg21 3 min21) from baseline to postintervention. Subgroup analyses evaluated whether treatment effects differed as a function of exercise prescription (ie, modality, schedule, length, supervision), study characteristics (ie, intervention timing, primary cancer site), and publication year. Safety was defined as report of any adverse event (AE); fidelity was evaluated by rates of attendance, adherence, and loss to follow-up. Results Forty-eight unique RCTs that represented 3,632 patients (mean standard deviation age, 55 6 7.5 years; 68% women); 1,990 (55%) and 1,642 (45%) allocated to exercise therapy and control/usual care groups, respectively, were evaluated. Exercise therapy was associated with a significant increase in CRF (+2.80 mL O2 3 kg21 3 min21) compared with no change (+0.02 mL O2 3 kg21 3 min21) in the control group (weighted mean differences, +2.13 mL O2 3 kg21 3 min21; 95% CI, 1.58 to 2.67; I2, 20.6; P, .001). No statistical significant differences were observed on the basis of any treatment effect modifiers. Thirty trials (63%) monitored AEs; a total of 44 AEs were reported. The mean standard deviation loss to follow-up, attendance, and adherence rates were 11% 6 13%, 84% 6 12%, and 88% 6 32%, respectively. Conclusion Exercise therapy is an effective adjunctive therapy to improve CRF in patients with cancer. Our findings support the recommendation of exercise therapy for patients with adult-onset cancer. © 2018 by American Society of Clinical Oncology
Journal Title: Journal of Clinical Oncology
Volume: 36
Issue: 22
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2018-08-01
Start Page: 2297
End Page: 2305
Language: English
DOI: 10.1200/jco.2017.77.5809
PROVIDER: scopus
PUBMED: 29894274
DOI/URL:
Notes: Review -- Export Date: 4 September 2018 -- Source: Scopus
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MSK Authors
  1. Chau Dang
    156 Dang
  2. Chaya S. Moskowitz
    172 Moskowitz
  3. Emily Craig Zabor
    121 Zabor
  4. Neil Mukund Iyengar
    63 Iyengar
  5. Lee Winston Jones
    101 Jones
  6. Scott C Adams
    4 Adams
  7. Jessica M Scott
    11 Scott