[Training to improve quality of life and physical functioning in cancer; which type of training, for which patient, and at which moment?]

OBJECTIVE: To investigate whether the effects of exercise on quality of life and physical functioning in patients with cancer is dependent upon certain patient characteristics or on specific training programmes. DESIGN: Meta-analysis of individual patient data (IPD) and a standard meta-analysis of randomized interventional studies. METHOD: Results from various randomized interventional studies were pooled for the analysis. Differences in effects of exercise among patients with different demographic and clinical characteristics were investigated using interaction terms applied to IPD. Differences in the effects of different training programmes were studied via subgroup analyses on published data. RESULTS: We found a small but significant positive effect of physical training on quality of life and physical functioning. In the IPD meta-analysis, we found no differences in the effects of physical training among patients with different demographic and clinical characteristics. In both the IPD and the standard meta-analysis we found a significant difference in the effect on quality of life (p < 0.01) and physical functioning (p = 0.01) between supervised and non-supervised training. In the standard meta-analysis we found a significantly greater effect of non-supervised training when the predetermined weekly energy use was higher. CONCLUSION: Results showed that physical training during and after cancer treatment can lead to improvement in quality of life and physical functioning. There was no difference in effect among different patient groups. Supervised training programmes resulted in greater effects than non-supervised training programmes. The effects of non-supervised training programmes were greater when the predetermined weekly energy use was higher.