Abstract
BackgroundSurgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population.MethodsA systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study.ResultsTwelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating.ConclusionsHigh quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.
Highlights
Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality
The toxicities of pancreatic cancer treatment are associated with impaired physical function and health related quality of life (HRQoL) and may contribute to greater morbidity and mortality in these patients
The purpose of this review is to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population
Summary
Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. Current exercise efficacy and prescription in pancreatic cancer is unknown. This study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Surgical resection remains the only potentially curative treatment for PDAC; only 10–20% of individuals have clearly. The toxicities of pancreatic cancer treatment are associated with impaired physical function and health related quality of life (HRQoL) and may contribute to greater morbidity and mortality in these patients. There is a need for adjunct therapies to counteract these treatment complications
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