Exercise during chemotherapy or chemoradiotherapy and treatment delivery and tumor response outcomes: a scoping review

Sep 22, 2026

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Exercise during cancer treatment is proposed as supportive care and as a biologically active intervention with potential systemic effects. Mechanistic work suggests exercise can modulate immune function and trigger systemic signaling through exerkines, which may affect how patients respond to anticancer therapies. However, evidence on links between exercise and treatment delivery outcomes (e.g., relative dose intensity, completion) as well as tumor response remains limited and heterogeneous. This scoping review maps current literature, summarizes associations, and identifies patterns and gaps to guide future research.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages28

Reading Time1 h 11 min

AccessFree to download

Background

Exercise as biologically active cancer therapy

Treatment delivery and tumor response rationale

Methods

Database search and study inclusion

Results

Included studies and cancer types

Treatment delivery and tolerance outcomes

Tumor response outcomes

Exercise modality, supervision, intensity, and frequency

Conclusions

Inconsistent associations and research recommendations

Fukushima et al. BMC Cancer (2026) 26:723 BMC Cancer [https://doi.org/10.1186/s12885-026-15992-6](https://doi.org/10.1186/s12885-026-15992-6) RESEARCH Open Access Exercise during chemotherapy or chemoradiotherapy and treatment delivery and tumor response outcomes: a scoping review Takuya Fukushima 1, Jiro Nakano1, Katsuyoshi Suzuki2, Keiichi Osaki3, Takashi Tanaka4, Taro Okayama2, Junichiro Inoue5, Jack B. Fu6 and Shinichiro Morishita7* Abstract Background Exercise 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. Methods We 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. Results Following 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. *Correspondence: Shinichiro Morishita [morishit@fmu.ac.jp](morishit@fmu.ac.jp) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Fukushima et al. BMC Cancer (2026) 26:723 Page 2 of 28 Conclusions Current 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 shou

FAQs

What outcomes does the scoping review focus on regarding exercise during treatment?

The review targets treatment delivery and tolerance outcomes, such as relative dose intensity, dose delay or reduction, and treatment completion, as well as tumor response outcomes including pathological complete response, tumor size, RECIST-based response, and downstaging.

How was the literature search performed?

Databases searched included PubMed/MEDLINE, Cochrane Library, and CINAHL Complete from inception to November 6, 2025, including studies that examined associations between exercise interventions and treatment-related outcomes in cancer patients.

What does the review conclude about the association between exercise and outcomes?

Current evidence shows inconsistent associations between exercise and selected treatment delivery and tumor response outcomes, suggesting a potential context-dependent role of exercise under specific conditions. The review recommends clearer differentiation among tolerance, delivery, and tumor response outcomes in future studies.

Sep 22, 2026

Uploaded by Dipper