Effects of exercise during radiotherapy on physical function and treatment-related side effects in men with prostate cancer: a systematic review and meta-analysis
A partir d'une revue systématique de la littérature publiée jusqu'en décembre 2020 (7 études, 6 essais randomisés, 391 patients), cette méta-analyse évalue l'effet, sur la fonction physique et les effets indésirables liés au traitement, de la pratique d'une activité physique pendant la radiothérapie chez les patients atteints d'un cancer de la prostate
Background: Radiotherapy is a commonly used treatment for prostate cancer; however, the side effects may negatively impact on quality of life and cause patients to be less physically active. While exercise has been shown to mitigate radiotherapy-related fatigue in men with prostate cancer during radiotherapy, other adverse effects of treatment such as physical deconditioning, urinary symptoms or sexual dysfunction have not been systematically reviewed in this patient population. Thus, the purpose of this review was to investigate the effect of exercise on physical function and treatment-related side effects in men with prostate cancer undergoing radiotherapy. Methods: A systematic literature search was conducted in PubMed, Embase, CINAHL Plus, SPORTDiscus, and Web of Science databases in December 2020. Included studies were randomised controlled trials examining the effects of aerobic and/or resistance exercise interventions on measures of physical function and treatment-related side effects in prostate cancer patients undergoing radiotherapy. Meta-analysis was performed on outcomes that were reported in two or more studies. Results: Seven publications from 6 randomised controlled trials involving 391 prostate cancer patients were included. Patients had stage I-IV cancer with a Gleason score of ≤6 to 10. Exercise resulted in consistent significant benefits for physical function in terms of cardiovascular fitness (SMD=0.83; 95% CI, 0.31 to 1.36; p<.01) and muscle function (SMD=1.30; 95% CI, 0.53 to 2.07; p<.01). Furthermore, there was a significant positive impact of exercise on urinary toxicity (SMD=-0.71; 95% CI, -1.25 to -0.18; p<.01), but not on intestinal (p=.21) or hormonal toxicity (p=.41), depression (p=.45) or sleep symptoms (p=.88). Conclusion: Based on the current evidence, exercise in men with prostate cancer undergoing radiotherapy improves physical function and mitigates urinary toxicity. The impact of exercise on other treatment-related side effects are less clear and require further investigation.
International Journal of Radiation Oncology, Biology, Physics 2021