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. 2025 Jun:210:104718.
doi: 10.1016/j.critrevonc.2025.104718. Epub 2025 Apr 5.

Physical activity guidelines in oncology: A systematic review of the current recommendations

Alice Avancini  1 , Anita Borsati  2 , Linda Toniolo  3 , Christian Ciurnelli  4 , Lorenzo Belluomini  5 , Thomas Budolfsen  6 , Christian Lillelund  7 , Michele Milella  8 , Morten Quist  9 , Sara Pilotto  10
Affiliations
Free article

Physical activity guidelines in oncology: A systematic review of the current recommendations

Alice Avancini et al. Crit Rev Oncol Hematol. 2025 Jun.
Free article

Abstract

This review aims to summarize the recommendations endorsed by scientific societies regarding physical activity for patients with cancer. A systematic search was conducted to identify guidelines endorsed by scientific societies and published in the last 15 years dedicated to physical activity for cancer patients. The AGREE II instrument was used to assess the methodological quality of the guidelines. Results are presented as qualitative synthesis. A total of 11 guidelines met the inclusion criteria. Seven were considered high quality, scoring ≥60 % in the AGREE II tool. All the guidelines recommended to include aerobic and resistance training as types of activities. Regarding the physical activity dosage, most suggested a generic 150 minutes/week of moderate-intensity activity plus resistance training twice a week. Three guidelines reported instructions for exercise prescription, including frequency, intensity, and duration of training sessions. Six guidelines reported exercise testing/medical clearance instructions, 9 provided considerations regarding adaptation/precautions, and 7 detailed the specialists for referral. Four guidelines considered motivational aspects related to physical activity and cancer. Although important steps have been made in the more recent recommendations, effort is needed to produce high-quality research in the exercise-oncology field, with the ultimate aim of developing more tailored guidelines.

Keywords: Cancer care; Guidelines; Physical activity; Physical activity recommendation.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: LB received payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing or educational events from AstraZeneca, Merck Sharp & Dohme, and Roche, outside the submitted manuscript; travel fees from Takeda. MM personal honoraria from AstraZeneca and MSD; travel expenses from AstraZeneca, outside the submitted manuscript. SP received consulting fees from AstraZeneca, MSD, Eli Lilly, Roche, AMGEN, Pierre-Fabre, Daichii-Sankyo, Pfizer, Boehringer Ingelheim, Regeneron; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing or educational events from AstraZeneca, MSD, Eli Lilly, Roche, AMGEN, Daichii-Sankyo, Boehringer Ingelheim, Johnson & Johnson, Novartis; support for attending meetings and/or travel from Roche, Johnson & Johnson, AMGEN, outside the submitted manuscript. The other authors declare no conflict of interest.

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