Crespo-Garcia · Current nutrition reports 2025 · systematic review · n=21 studies (1,384 participants)

Effects of Exercise or Diet or Combined Interventions on Treatment Efficacy of Chemotherapy for Cancer: A Systematic Review.

Level 1 - systematic review of randomized trials

Systematic review of controlled and uncontrolled intervention studies

PubMed 41366586 · doi:10.1007/s13668-025-00702-8 · record verified 2026-08-26

What was done

A systematic review following PRISMA guidelines was conducted across PubMed, Medline, CINAHL, Embase, and Web of Science to evaluate the effects of exercise, dietary, and combined interventions on tumour response and survival outcomes in cancer patients receiving chemotherapy. Risk of bias and methodological quality were assessed using RoB2 and ROBINS-I. A total of 21 intervention studies involving 1,384 cancer patients were included.

What was found

The abstract reports study counts rather than pooled statistical numbers: - Exercise interventions (13 studies; 9 controlled): 2 studies reported improvements in tumour response, but none showed a significant impact on survival outcomes. - Dietary interventions (7 studies; all ketogenic or fasting-mimicking diets; 3 controlled in breast cancer): 3 studies reported significant increases in tumour response and survival outcomes. - Combined exercise and diet (1 study): Reported a significant increase in pathological complete response rates.

Why it matters

This review aggregates current evidence on whether lifestyle adjuncts can directly enhance chemotherapy efficacy, identifying potential signals for ketogenic or fasting-mimicking diets while demonstrating that robust survival evidence remains lacking.

Limits

The abstract reports no pooled effect sizes, hazard ratios, or confidence intervals. Only 12 of the 21 included studies were controlled, diet studies were restricted to ketogenic or fasting-mimicking regimens primarily in breast cancer, and only one study evaluated combined interventions.

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