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Exercise intervention for post-treatment colorectal cancer survivors: a systematic review and meta-analysis

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Abstract

Purpose

This study aimed to explore the effects of exercise on post-treatment colorectal cancer survivors through a systematic review and meta-analysis as the current information is limited and controversial.

Methods

We searched PubMed, Web of Science, Embase, and Cochrane Library databases for randomized controlled trials that focused on exercise intervention for adult colorectal cancer survivors who had completed primary cancer treatment. We extracted and pooled information regarding psychosocial outcomes, physical functions, body composition, metabolic growth factors, and/or tumor-related biomarkers. All data were assessed by two independent reviewers. The risk of bias was assessed using the Cochrane Collaboration’s tool.

Results

A total of 20 studies, which presented data from 1223 post-treatment colorectal cancer survivors, matched the inclusion criteria. Compared with usual care or usual lifestyle, exercise intervention increased VO2peak (n = 107, SMD = 0.72, 95% CI = 0.32 to 1.11, I2 = 41%, P = 0.0004), reduced fasting insulin levels and insulin resistance (n = 150, SMD = − 0.55, 95% CI = − 0.88 to − 0.23, I2 = 0%, P = 0.0009; SMD = − 0.62, 95% CI = − 0.95 to − 0.29, I2 = 0%, P = 0.0002), and decreased levels of sICAM-1. Moderate-intensity exercise was associated with a more pro-inflammatory immune state, resulting in increased oxidative DNA damage. However, no evidence was found for effects of exercise on psychosocial outcomes or body composition.

Conclusions

Our results revealed that exercise could be a feasible and effective option for improving cardiopulmonary fitness, metabolism, and tumor-related biomarkers in post-treatment colorectal cancer survivors.

Implications for Cancer Survivors

Given the benefits of exercise for colorectal cancer survivors, they should be encouraged to become more physically active.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Funding

This study was funded by Project of Norman Bethune Health Science Center of Jilin University (No. 2018A04).

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Author notes

  1. Feng Li and Lirong Guo contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin, 130000, China

    Ruitong Gao, Tianzhuo Yu, Lu Liu, Feng Li & Lirong Guo

  2. Nursing Department, the First Bethune Hospital of Jilin University, Changchun, Jilin, 130021, China

    Jiasi Bi

  3. Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China

    Huiying Zhao

  4. School of Physical Education and Sport Training, Shanghai University of Sport, 650 Qingyuanhuan Road, Yangpu District, Shanghai, 200082, China

    Yujia Tao

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  1. Ruitong Gao
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  2. Tianzhuo Yu
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  3. Lu Liu
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Contributions

Ruitong Gao and Tianzhuo Yu designed the project. Ruitong Gao, Tianzhuo Yu, and Lu Liu performed the literature search. Ruitong Gao, Tianzhuo Yu, and Lu Liu performed data extraction and analysis. Jiasi Bi, Huiying Zhao, and Yujia Tao performed the quality assessment. Ruitong Gao, Tianzhuo Yu, Jiasi Bi, and Huiying Zhao contributed to the article drafting. Feng Li and Lirong Guo revised the manuscript critically and supervised the project. All authors read and approved the final manuscript.

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Correspondence to Feng Li or Lirong Guo.

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Gao, R., Yu, T., Liu, L. et al. Exercise intervention for post-treatment colorectal cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 14, 878–893 (2020). https://doi.org/10.1007/s11764-020-00900-z

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