A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy

Fan Yuan; Yang Wang; Xiwei Xiao; Xufan Zhang; Mingyi Jing; Hubert Kamecki; Yu Guang Tan; Silvia García Barreras; Jeanny B Aragon-Ching; Ziyang Ma; Peihai Zhang; Degui Chang; Yaodong You

doi:10.21037/tau-23-272

A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy

Transl Androl Urol. 2023 Aug 31;12(8):1336-1350. doi: 10.21037/tau-23-272. Epub 2023 Aug 4.

Authors

Fan Yuan^#^{1

2}, Yang Wang^#³, Xiwei Xiao^#⁴, Xufan Zhang^#⁴, Mingyi Jing^{1

2}, Hubert Kamecki⁵, Yu Guang Tan⁶, Silvia García Barreras⁷, Jeanny B Aragon-Ching^{8

9}, Ziyang Ma¹, Peihai Zhang¹, Degui Chang¹, Yaodong You^{1

2}

Affiliations

¹ Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
² Chengdu University of Traditional Chinese Medicine, Chengdu, China.
³ Department of Urology, the Affiliated Hospital of Chengdu University, Chengdu, China.
⁴ Department of Nuclear Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
⁵ Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.
⁶ Department of Urology, Singapore General Hospital, Singapore, Singapore.
⁷ Urology Department, Hospital Ramón y Cajal, IRYCIS, Alcalá University, Madrid, Spain.
⁸ GU Medical Oncology, Inova Schar Cancer Institute, Fairfax, VA, USA.
⁹ Department of Medicine, University of Virginia, Charlottesville, VA, USA.

^# Contributed equally.

Abstract

Background: Androgen deprivation therapy (ADT) is an effective prostate cancer (PCa) treatment strategy that can curb the development or progression of the disease. This review aimed to examine and summarize available systematic reviews/meta-analyses (SRs/MAs) of exercise training on physical condition of PCa patients undergoing ADT.

Methods: A comprehensive search of 8 databases was conducted for relevant literature published before April 25, 2022 with the language restrictions of Chinese and English. Two reviewers independently assessed the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs using a range of evaluation tools, including A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE).

Results: This review included 8 SRs/MAs which included a total of 94 studies. Ultimately, A total of 51 outcomes was included, regarding 11 different outcome categories. The AMSTAR-2 tool showed that 3 SRs/MAs had moderate methodological quality, 4 SRs/MAs had very low quality, and the remaining 1 had low quality. According to the ROBIS scale, 3 SRs/MAs had a high risk of bias. The PRISMA checklist showed that the primary reporting faults were protocol registration and funding source. The GRADE system was used to analyze the evidence quality of the 51 outcomes, and no high-quality evidence was found. However, moderate-quality evidence indicated that exercise training may improve body composition [by lowering body fat mass (BFM) and body fat rate (BFR)], muscular strength, and quality of life (QoL) in PCa patients undergoing ADT. Low-quality evidence demonstrated that exercise training could improve such symptoms as fatigue, depression, sexual function, and cardiometabolic changes.

Conclusions: Available evidence suggests that exercise training may be used as an adjuvant treatment for PCa patients undergoing ADT to improve several aspects of general health. Studies with more rigorous designs and larger sample sizes are needed to support our findings with more robust evidence.

Keywords: Exercise; prostate cancer (PCa); systematic review (SR).

Publication types

Review