Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Exercise across the lung cancer care continuum: an overview of systematic reviews (#80)

Lara Edbrooke 1 2 , Amy Bowman 1 3 , Catherine L Granger 1 4 , Nicola Burgess 5 , Shaza Abo 1 3 4 , Bronwen Connolly 6 , Linda Denehy 1 2
  1. Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
  2. Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. Physiotherapy, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  4. Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. Physiotherapy, Austin Health, Melbourne, Victoria, Australia
  6. Wellcome-Wolfson Institute for Experimental Research, Queen's University Belfast, Belfast, United Kingdom

Aims: Growing evidence supports exercise for people with lung cancer. This overview aimed to summarise exercise intervention effects across the care continuum. A secondary aim was to report the most effective exercise types and settings.

 

Methods: Eight databases (including Cochrane, MEDLINE, CINAHL) were searched (inception-February 2022) for systematic reviews of RCTs/quasi RCTs. Eligibility: population: adults with lung cancer; intervention: exercise (e.g., aerobic, resistance, balance, respiratory muscle training) +/- non-exercise (e.g., nutrition, psychological); comparator: usual care or non-exercise only; primary outcomes: exercise capacity, physical function, health-related quality of life (HRQoL) and post-operative complications. Duplicate, independent title/abstract and full-text screening, data extraction and quality ratings (AMSTAR-2) were completed.

 

Results: Thirty systematic reviews involving between 157 to 2109 participants were included. Most reviews (n=27) involved surgical participants (8 prehabilitation, 4 post-operative, 4 pre+post-operative, 9 mixed surgical+non-surgical) and 25 performed meta-analyses. Review quality was commonly rated critically low (n=22) or low (n=7). Prehabilitation meta-analyses (n=8) supported exercise in reducing post-operative complications and improving exercise capacity (n=6), whilst HRQoL findings were non-significant (n=3). Post-operative meta-analyses reported significant improvements in exercise capacity (n=2 out of 3) and muscle strength (n=1) and non-significant HRQoL changes (n=3 out of 4). One review reported reduced post-operative complications with pre-operative compared to post-operative interventions. Interventions delivered to mixed surgical and non-surgical populations improved exercise capacity (n=4 out of 5 meta-analyses), muscle strength (n=1) and HRQoL (n=3). Meta-analyses of interventions in non-surgical populations demonstrated inconsistent findings for changes in exercise capacity and HRQoL (n=2).

 

Conclusions: A large body of evidence supports lung cancer exercise interventions to reduce complications and improve physical function in pre- and post-operative populations. Additional higher-quality research is needed, particularly in the non-surgical population, with subgroup analyses of exercise type and setting.

 

Registration: PROSPERO CRD42015001068

Funding: The University of Melbourne (2021ECR097)