Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, MP 307, Tremona Road, Southampton, SO16 6YD, UK.
Department of Acute Internal Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Support Care Cancer. 2018 Oct;26(10):3337-3351. doi: 10.1007/s00520-018-4295-x. Epub 2018 Jun 24.
Aerobic exercise improves prognosis and quality of life (QoL) following completion of chemotherapy. However, the safety and efficacy of aerobic exercise during chemotherapy is less certain. A systematic review was performed of randomised trials of adult patients undergoing chemotherapy, comparing an exercise intervention with standard care.
From 253 abstracts screened, 33 unique trials were appraised in accordance with PRISMA guidance, including 3257 patients. Interventions included walking, jogging or cycling, and 23 were of moderate intensity (50-80% maximum heart rate).
Aerobic exercise improved, or at least maintained fitness during chemotherapy. Moderately intense exercise, up to 70-80% of maximum heart rate, was safe. Any reported adverse effects of exercise were mild and self-limiting, but reporting was inconsistent. Adherence was good (median 72%). Exercise improved QoL and physical functioning, with earlier return to work. Two out of four studies reported improved chemotherapy completion rates. Four out of six studies reported reduced chemotherapy toxicity. There was no evidence that exercise reduced myelosuppression or improved response rate or survival.
Exercise during chemotherapy is safe and should be encouraged because of beneficial effects on QoL and physical functioning. More research is required to determine the impact on chemotherapy completion rates and prognosis.
有氧运动可改善化疗完成后的预后和生活质量（QoL）。然而，化疗期间进行有氧运动的安全性和疗效尚不确定。我们对接受化疗的成年患者的随机试验进行了系统评价，比较了运动干预与标准护理。
从筛选出的 253 篇摘要中，根据 PRISMA 指南评估了 33 项独特的试验，包括 3257 名患者。干预措施包括散步、慢跑或骑自行车，其中 23 项为中等强度（最大心率的 50-80%）。
有氧运动可改善化疗期间的体能，或至少保持体能。中等强度的运动，最大心率的 70-80%，是安全的。任何报告的运动相关不良影响均为轻度且自限性的，但报告不一致。锻炼的依从性良好（中位数 72%）。运动可改善生活质量和身体功能，更早恢复工作。四项研究中的两项报告提高了化疗完成率。六项研究中有四项报告减少了化疗毒性。没有证据表明运动可减少骨髓抑制，或提高缓解率或生存率。
化疗期间进行运动是安全的，应该鼓励进行，因为它对生活质量和身体功能有有益影响。需要更多的研究来确定其对化疗完成率和预后的影响。
