Background/Objectives:Chemotherapy is an aggressive form of oncological treatment often accompanied by numerous adverse effects. A patient’s baseline status significantly influences the course of therapy, its efficacy, quality of life, and overall survival. This review aims to analyze the published peer-reviewed studies in this area and to assess whether they permit the formulation of preliminary recommendations for future prehabilitation protocols.Methods:An integrative review was conducted due to the limited number of relevant studies. Four databases—MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online/National Library of Medicine), Scopus, Cochrane, and Web of Science—were systematically searched for English-language articles published between 2010 and 13 January 2025, using the terms “prehabilitation,” “chemotherapy,” “drug therapy,” and “neoadjuvant.” A total of 162 records were retrieved. After duplicate removal, titles and abstracts were screened. The remaining papers were subjected to detailed analysis, resulting in ten studies with diverse methodologies being included.Results:We reviewed ten (n= 10) studies, most of which were reviews focused on breast cancer, indicating variation in the state of knowledge across different cancer types. A protein intake of 1.4 g/kg body mass helps preserve fat-free mass, with whey being more effective than casein. Supplementing EPA at a dose of 2.2 g/day may help prevent chemotherapy-related neurotoxicity and support appetite and weight maintenance. Physical activity, especially when it includes strength training, improves VO2max, preserves fat-free mass, and may reduce stress and anxiety. We identified one randomized controlled trial in which a single exercise session before the first dose of doxorubicin resulted in a smaller reduction in cardiac function. Continuous psychological support should be available. A combined behavioural and pharmacological approach appears to be the most effective strategy for smoking cessation.Conclusions:No official guidelines exist for prehabilitation before chemotherapy, and the availability of studies on this topic is very limited. The pre-treatment period represents a critical window for interventions. Further research is needed to evaluate the effectiveness and applicability of particularly single-component interventions.
背景/目的：化疗作为一种积极的肿瘤治疗手段，常伴随多种不良反应。患者的基线状态显著影响治疗进程、疗效、生活质量及总体生存率。本综述旨在分析该领域已发表的同行评议研究，评估其是否能为未来预康复方案的制定提供初步建议。 方法：由于相关研究数量有限，本研究采用整合性综述方法。系统检索了MEDLINE/PubMed（医学文献分析与检索系统/美国国立医学图书馆）、Scopus、Cochrane和Web of Science四个数据库，检索时限为2010年至2025年1月13日，使用“预康复”“化疗”“药物治疗”“新辅助”等英文检索词，共获得162条记录。剔除重复文献后，对标题和摘要进行筛选，最终对剩余文献进行详细分析，共纳入10项采用不同研究方法的研究。 结果：我们分析了10项研究，其中多数为针对乳腺癌的综述，表明不同癌症类型的认知水平存在差异。每日每公斤体重摄入1.4克蛋白质有助于维持去脂体重，且乳清蛋白效果优于酪蛋白。每日补充2.2克二十碳五烯酸（EPA）可能有助于预防化疗相关神经毒性，并维持食欲和体重。体育锻炼（特别是包含力量训练时）可提高最大摄氧量、保持去脂体重，并可能减轻压力与焦虑。我们发现一项随机对照试验表明，在首次使用阿霉素前进行单次运动可减轻心功能下降程度。应提供持续的心理支持。行为干预与药物干预相结合似乎是戒烟最有效的策略。 结论：目前尚无化疗前预康复的官方指南，该主题的研究极为有限。治疗前阶段是实施干预的关键窗口期。未来需进一步研究评估单一干预措施的有效性与适用性。
Prehabilitation Prior to Chemotherapy in Humans: A Review of Current Evidence and Future Directions
肿瘤(癌症)患者之家