Effect of Exercise Therapy During Treatment for Gynecological Cancer: A Systematic Review and Meta-Analysis: 921 Board #155 May 29 3:30 PM - 5:00 PM

Side effects of gynecological cancer treatments (GCT), such as cancer related fatigue, physical pain, lower limb lymphedema, induced menopause and sexual dysfunction, negatively affect the patients’ Quality of Life (QoL). PURPOSE: To evaluate the effect of exercise therapy in randomized controlled trials (RCTs) on QoL in women during GCT. Secondary outcomes were the effects on body composition (BC), training modality, safety and physical activity (PA) behavior. METHODS: A systematic search in PubMed, Cochrane, EMBASE and SPORTDiscus was carried out to identify exercise training RCTs during GCT. Primary endpoint was the change in QoL from baseline (PRE) to after (POST) exercise intervention. Exclusion criteria was investigations with participants’ mean age <18years, not written in English and not published in peer-review journals. Meta-analysis of Standardized Mean Differences (SMD) and 95% Confidence Interval (95%CI) were performed. RESULTS: Seven RCTs were selected, including a total of 112 and 105 participants in the exercise therapy and the control group, respectively. Four studies underwent unsupervised, home-based (HB) exercise; one study received instructions for unsupervised HB training (walking and strength exercises); one study received a comprehensive care program (group education and self-help group support, relaxation and HB aerobic and strength exercises); one study underwent pelvic floor rehabilitation training supervised by a physiotherapist and instructions for HB exercise. After the exercise therapy an increase in PA has been reported for all included studies (SMD=0.56, 95%CI: 0.38, 0.74). Exercise therapy did not show any significant differences in waist circumference (PRE:65.5±33.1cm; POST:64.9±33.6cm; SMD=-0.10, 95%CI: -0.78, 0.59), body mass (PRE: 105.6±7.4kg; POST:102±7.8kg; SMD=-0.09, 95%CI: -0.67, 0.50) or BMI (PRE:29.5±8.3kg/m-2; POST:30±8.2 kg/m-2; SMD=0.01, 95%CI: -0.67, 0.70), compared to the control groups. No adverse events were reported during the exercise intervention. CONCLUSION: Exercise therapy during GCT showed improvements in PA and QoL. However, exercise therapy seems safe during GCT. Further research is needed to evaluate effect of supervised exercise interventions on cardiorespiratory fitness, type, frequency and training intensity.