Scott JM, et al. - Researchers assessed data from randomized controlled trials (RCTs) reporting the impacts of exercise therapy on cardiorespiratory fitness (CRF) among patients with adult-onset cancer. They also evaluated treatment effect modifiers, safety, and fidelity. They found that improved CRF was effectively achieved by exercise therapy in patients with cancer when used as an adjunctive therapy. The recommendation of exercise therapy for patients with adult-onset cancer was supported.

Methods

• Researchers identified RCTs that compared exercise therapy to a nonexercise control group, via performing a systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library.
• Change in CRF as assessed by peak oxygen consumption (VO_2peak; in mL O₂ × kg^-1 × min^-1) from baseline to postintervention was the primary end point.
• They also carried out subgroup analyses to assess if treatment impacts differed as a function of exercise prescription (ie, modality, schedule, length, supervision), study characteristics (ie, intervention timing, primary cancer site), and publication year.
• Report of any adverse event (AE) defined safety, and rates of attendance, adherence, and loss to follow-up were considered to assess fidelity.

Results

• Analysis included 48 unique RCTs that represented 3,632 patients (mean standard deviation age, 55 ± 7.5 years; 68% women); 1,990 (55%) and 1,642 (45%) allocated to exercise therapy and control/usual care groups, respectively.
• Findings revealed correlation of exercise therapy with a significant increase in CRF (+2.80 mL O₂ × kg^-1 × min^-1) compared with no change (+0.02 mL O₂ × kg^-1 × min^-1) in the control group (weighted mean differences, +2.13 mL O₂ × kg^-1 × min^-1; 95% CI, 1.58 to 2.67; I², 20.6; P < .001).
• Based on any treatment effect modifiers, they found no statistical significant differences.
• Data showed that 30 trials (63%) monitored AEs, in which 44 AEs were reported.
• They found that the mean standard deviation loss to follow-up, attendance, and adherence rates were 11% ± 13%, 84% ± 12%, and 88% ± 32%, respectively.