ArticleBMC cancer2026
Exercise during chemotherapy or chemoradiotherapy and treatment delivery and tumor response outcomes: a scoping review.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
9 authors.
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Abstract
backgroundExercise during cancer treatment has been proposed not only as supportive care but also as a biologically active intervention with potential systemic effects. Mechanistic studies suggest that exercise modulates immune function and induces systemic signaling through exerkines, which may influence responsiveness to cancer therapies. However, evidence regarding exercise effects on treatment delivery, such as relative dose intensity, treatment completion, and tumor response, remains limited and heterogeneous. This scoping review aimed to map and summarize existing literature on associations between exercise, treatment delivery, and tumor response outcomes, highlighting patterns and gaps that inform future research.
methodsWe searched the PubMed/MEDLINE, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature Complete databases from inception to November 6, 2025. Studies examining the association between exercise interventions and treatment-related outcomes in patients with cancer were included.
resultsFollowing eligibility assessment, 23 studies comprising 31 exercise interventions were included. Most studies have focused on breast and colorectal cancers and spanned various treatment phases, ranging from neoadjuvant to adjuvant settings. Treatment-related outcomes most commonly reflected treatment delivery and tolerance (e.g., relative dose intensity, dose delay or reduction, and treatment completion). Moreover, tumor response outcomes were reported, including pathological complete response, tumor size, response according to RECIST, and downstaging. Exercise interventions commonly consisted of aerobic exercise alone or in combination with resistance training, were predominantly supervised, and were often prescribed at moderate-to-high intensities, with a frequency of three to four sessions per week. Associations with favorable treatment-related outcomes were more frequently reported for supervised, moderate-to-high intensity exercise; however, null findings were common across all outcomes and cancer types.
conclusionsCurrent evidence indicates an inconsistent association between exercise and selected treatment delivery and tumor response outcomes in patients with cancer, suggesting a potential, context-dependent role of exercise under specific conditions. Future studies should clearly differentiate among treatment tolerance, delivery, and tumor response outcomes and investigate whether—and how—exercise influences these outcomes across various cancer types and treatment phases.
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