Prehabilitation in radiation therapy: a scoping review

Area of Science:

• Oncology
• Radiotherapy
• Rehabilitation Medicine

Background:

• Radiation therapy (RT) is a cornerstone of cancer treatment, offering survival and quality-of-life benefits.
• RT can lead to significant side effects, including fatigue, pain, weight loss, and mental health changes.
• Prehabilitation aims to optimize patient health before cancer treatment to mitigate side effects and improve outcomes.

Purpose of the Study:

• To conduct a scoping review of existing literature on prehabilitation interventions for patients undergoing radiation therapy (RT).
• To summarize the current evidence regarding the efficacy and application of prehabilitation in the context of RT for cancer patients.

Main Methods:

• A comprehensive literature search was conducted using PRISMA-ScR guidelines, covering studies from October 2002 to October 2022.
• The review identified and evaluated studies investigating prehabilitation interventions implemented before or during RT in adult cancer patients.
• A total of 30 articles, including 18 randomized controlled trials (RCTs), were included in the analysis.

Main Results:

• The most studied populations included patients with head and neck, rectal, breast, and lung cancers.
• Unimodal interventions were most common, with targeted physical exercises being the most frequent type.
• Adherence and feasibility were the primary outcomes in 30% of the studies; data on race/ethnicity were reported in only 17% of studies.

Conclusions:

• Prehabilitation has demonstrated success in surgical cancer patients and shows potential for reducing morbidity in those undergoing RT.
• Current literature, while containing RCTs, often features small sample sizes and focuses on feasibility rather than functional outcomes.
• There is a critical need for large-scale, randomized controlled trials to rigorously assess prehabilitation's efficacy and optimize outcomes for RT patients.