Purpose: The effectiveness and feasibility of cancer prehabilitation have been well-validated in surgical settings, but its role in non-surgical treatments, such as chemotherapy and radiotherapy (RT), remains unclear. This scoping review aims to systematically explore the existing literature on prehabilitation programs for non-surgical cancer treatments.Methods: Following the scoping review methodology developed by the Joanna Briggs Institute, seven databases were systematically searched from their inception to October 2024 for peer-reviewed studies involving prehabilitation prior to non-surgical treatment. Data were extracted and reported adhering to PRISMA-ScR guidelines, using a convergent synthesis design to present qualitative and quantitative evidence. No formal risk-of-bias or quality appraisal was conducted.Results: Of 22,122 studies, 39 met the inclusion criteria, yielding a combined sample of 6073 patients and thirty-four unique interventions. Sample sizes ranged from 9 to 1992, with randomized control trials being the most common (16). Head and neck cancer was the most frequently studied, followed by breast, esophageal/gastric, and lung cancer. Of the included interventions, 23 were unimodal and 16 were multimodal. Exercise was the most common component (30), with nutrition (13), psychosocial (10), and educational (8) components also present. Most efficacy studies (84%) reported improved outcomes and nearly all (93%) feasibility studies found prehabilitation acceptable and implementable.Conclusions: This review highlights a growing body of literature examining prehabilitation prior to chemotherapy or RT in adult cancer patients, with studies suggesting potential benefits and feasibility. However, long-term trials, especially in diverse cancers and older populations, remain scarce. Our results provide insight into future implementation, evaluation of outcomes, and directions for future prehabilitation research.
目的：癌症预康复的有效性与可行性已在手术领域得到充分验证，但其在化疗和放疗等非手术治疗中的作用尚不明确。本范围综述旨在系统梳理非手术癌症治疗预康复方案的现有文献。方法：遵循乔安娜布里格斯研究所制定的范围综述方法，系统检索七个数据库自建库至2024年10月期间涉及非手术治疗前预康复的同行评审研究。采用收敛性合成设计提取和报告数据，遵循PRISMA-ScR指南呈现定性与定量证据，未进行正式偏倚风险或质量评估。结果：在22,122篇研究中，有39项符合纳入标准，共涉及6,073例患者及34种独立干预方案。样本量从9至1,992例不等，其中随机对照试验最为常见（16项）。头颈癌是最常研究的癌种，其次为乳腺癌、食管/胃癌和肺癌。在纳入的干预方案中，23项为单模态干预，16项为多模态干预。运动是最常见的干预成分（30项），其次为营养支持（13项）、心理社会干预（10项）和教育指导（8项）。多数有效性研究（84%）报告了改善结果，几乎所有可行性研究（93%）均认为预康复方案可接受且可实施。结论：本综述表明，针对成年癌症患者化疗或放疗前预康复的研究文献日益丰富，相关研究提示其潜在益处和可行性。然而，长期临床试验仍然匮乏，特别是在多样化癌种及老年人群中。本研究结果为未来实践实施、结局评估及预康复研究方向提供了重要参考。
Prehabilitation in Adult Cancer Patients Undergoing Chemotherapy or Radiotherapy: A Scoping Review
肿瘤(癌症)患者之家