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


MeSH Major

  • Amenorrhea
  • Antineoplastic Combined Chemotherapy Protocols
  • Breast Neoplasms


  • © 2018 by American Society of Clinical Oncology 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 O23 kg213 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 O23 kg213 min21) compared with no change (+0.02 mL O23 kg213 min21) in the control group (weighted mean differences, +2.13 mL O23 kg213 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.

publication date

  • August 2018



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1200/JCO.2017.77.5809

PubMed ID

  • 29894274

Additional Document Info

start page

  • 2297

end page

  • 2305


  • 36


  • 22