Prehabilitation in Adult Cancer Patients Undergoing Chemotherapy or Radiotherapy: A Scoping Review

Area of Science:

• Oncology
• Rehabilitation Medicine
• Evidence Synthesis

Background:

• Cancer prehabilitation is established for surgical patients but its role in non-surgical treatments like chemotherapy and radiotherapy is less understood.
• Existing literature on prehabilitation for non-surgical cancer treatments requires systematic exploration to guide clinical practice and future research.

Purpose of the Study:

• To systematically review and synthesize the evidence on prehabilitation programs implemented before non-surgical cancer treatments.
• To assess the reported efficacy and feasibility of prehabilitation in adult cancer patients undergoing chemotherapy or radiotherapy.

Main Methods:

• A comprehensive scoping review methodology was employed, adhering to Joanna Briggs Institute guidelines.
• Seven databases were searched from inception to October 2024, including 39 studies with 6073 patients and 34 unique interventions.
• Data extraction and reporting followed PRISMA-ScR guidelines, using a convergent synthesis approach for qualitative and quantitative findings.

Main Results:

• The review identified 39 studies, predominantly randomized controlled trials, focusing on head and neck, breast, esophageal/gastric, and lung cancers.
• Interventions included unimodal (n=23) and multimodal (n=16) approaches, with exercise being the most common component (30 studies).
• Eighty-four percent of efficacy studies reported improved outcomes, and 93% of feasibility studies found prehabilitation acceptable and implementable.

Conclusions:

• Prehabilitation prior to chemotherapy or radiotherapy is a growing area of research with demonstrated potential benefits and feasibility in adult cancer patients.
• There is a need for more long-term trials, especially in a wider range of cancer types and in older patient populations.
• The findings offer valuable insights for future implementation strategies, outcome evaluation, and research directions in cancer prehabilitation.