The primary objective was to determine the effects of RT on quality of life, fatigue, and pain, as well as dose-response associations between total exercise volume and changes in outcomes.
The secondary objective was to analyze how exercise variables have been used to prescribe radiotherapy to patients undergoing oncologic treatment.
A systematic search was performed in PubMed, Web of Science, CINAHL, and SCOPUS databases. Randomized controlled trials (RCTs) of RT in patients undergoing oncologic therapy (surgery, chemotherapy, radiotherapy, hormonal therapy, androgen deprivation, and/or immunotherapy) were included. The effect of RT on quality of life, fatigue, and pain intensity was analyzed using a random-effects meta-analysis. To assess the dose-response relationship between total exercise volume (the total number of repetitions during the RT program) and changes in outcomes, a one-stage mean difference dose-response meta-analysis was performed.
Nineteen RCTs were included (n=989, 56.1% women). Compared to control interventions, 6/14 (42.9%) trials found improvements in QoL, 8/14 (57.1%) in fatigue and 2/4 (50%) in pain. Meta-analysis was only possible in breast and prostate cancer. In breast cancer, a statistically significant difference in favor of RT was observed for fatigue (k=6, SMD=-0.30, 95% CI -0.46 to -0.14; p0.001) and pain reduction (k=3, SMD=-0.25, 95% CI -0.48 to -0.02; p0.032). The dose-response relationship between total exercise volume and the effect on fatigue showed a J-shape, with maximum effect at 2800 total repetitions, and a linear relationship was observed with a moderate effect at 8800 repetitions of RT for QoL. In prostate cancer, there was a trend in favor of RT for fatigue reduction (p=0.072). No improvement in QoL. In RT programs taught by physical therapists, information on important exercise variables was underreported (rest between sets: 21%, pain threshold: 11%, therapist experience:16%, Time under tension: 0% and internal/external focus: 0%).
RT offers benefits to patients undergoing cancer therapy, particularly in reducing fatigue in breast cancer patients. For breast cancer patients, the dose-response relationship between total exercise volume and the effect on fatigue and quality of life was J-shaped (2800 repetitions for a maximal effect) and linear (8800 repetitions for a moderate effect), respectively. Despite its benefits, the variables of exercise training prescription are poorly documented.
These results can guide and optimize physiotherapists in the implementation of RT in intervention programs in patients undergoing cancer therapy.
Resistance training
Physiotherapy
