Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Effect of exercise training on chemotherapy completion rates in individuals with cancer: A systematic review (#243)

Kelcey A Bland 1 , Kendra Zadravec 2 , Taryne Landry 2 , Sarah Weller 2 , Logan Meyers 2 , Kristin L Campbell 2
  1. Australian Catholic University, Melbourne, Australia
  2. University of British Columbia, Vancouver, Canada

Receipt of full chemotherapy dose intensity is associated with improved treatment efficacy, disease control, and survival among individuals with cancer. Exercise has emerged as an integrative intervention that may mediate chemotherapy dose-limiting side effects and potentially influence patient chemotherapy completion rates. Aim: To conduct a systematic review to evaluate the influence of exercise interventions on chemotherapy completion rate outcomes in adult cancer patients. Methods: Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE based on subject headings and keywords pertaining to cancer (e.g. neoplasm), exercise (e.g. physical activity, aerobic exercise, and strength training), and chemotherapy (e.g. antineoplastic). Title, abstract, and full-text screening was performed using Covidence. Articles included in this review were randomized trials or single-arm trials with a comparison group that prescribed an aerobic and/or strength training exercise program during chemotherapy, and included end-points relating to chemotherapy completion rates. Results: Chemotherapy completion rates were evaluated in a total of six randomized control trials, one randomized trial with no control group, and two single-arm trials with comparison groups. Chemotherapy completion rates were evaluated as secondary outcomes in all eligible trials. Chemotherapy completion rate outcome definitions included mean/median/minimum relative dose intensity (RDI) or RDI ≥ 85% (n=4), planned minimum/maximum cycles and chemotherapy response (n=1), rate of chemotherapy interruption (n=1), % participants requiring dose adjustment/mean dose adjustment/receipt of planned dose (n=1), time to start chemotherapy cycle 2 (n=1), and dose intensity (n=1). In total, two randomized and two single-arm trials reported a statistically significant beneficial effect of exercise on chemotherapy completion rates, including mean RDI, ranging from 90-95% with exercise vs. 80-84% without exercise. The remaining five studies showed no difference by group. Conclusion: Despite the rapid growth in number of exercise oncology trials to-date, little information on the effect of exercise on chemotherapy completion rate outcomes exists. Current evidence includes conflicting and non-validated outcome definitions, heterogeneous and small study samples, and varying exercise interventions. Given the prognostic importance of receiving the full planned chemotherapy dose and duration, designing exercise trials to evaluate chemotherapy completion rates as a primary outcome is needed.