Prehabilitation A forgotten strategy in pediatric oncology?
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Abstract
Introduction: Advances in childhood cancer treatment have increased survival rates, underscoring the need to address treatment-related late effects and long-term functional outcomes. Prehabilitation aims to optimize physical, psychological, and nutritional status before treatment to improve subsequent outcomes; however, it remains a poorly defined and understudied concept in paediatric oncology. Materials and Methods: Following PRISMA guidelines, a systematic search of PubMed and EMBASE databases was conducted for English-language publications from 2015 to 2025 investigating the effects of pre-treatment exercise-based interventions in paediatric cancer patients. Results: Limited evidence exists regarding the role of prehabilitation in paediatric oncology. However, benefits of implementing ERAS protocols in paediatric orthopaedics have been observed. Additionally, implementation of physical exercise during and after oncologic treatment also offers positive results. Although no standardized paediatric recommendations exist, studies in adult populations demonstrate benefits secondary to prehabilitation. Discussion: Considerable heterogeneity exists in terms of exercise regimens, timing of interventions, and outcome measures. Despite this, evidence from paediatric surgery and adult oncology suggests a potential beneficial role for prehabilitation in paediatric oncology. Conclusion: Available evidence supports the potential value of prehabilitation and highlights the need for structured, multidimensional intervention studies incorporating exercise, nutritional support, and psychological care in paediatric oncology.
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References
Braam, K. I., van der Torre, P., Takken, T., Veening, M. A., van Dulmen-den Broeder, E., & Kaspers, G. J. (2016). Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. The Cochrane database of systematic reviews, 3(3), CD008796. https://doi.org/10.1002/14651858.CD008796.pub3
den Hartog, E., Lindemans, C.A., Fiocco, M., Tissing, W. J. E., & Verwaaijen, E. J. (2024). Physical performance before and after hematopoietic stem cell transplantation in pediatric patients: a potential role for prehabilitation. Bone Marrow Transplant 59, 1499-1505. https://doi.org/10.1038/s41409-024-02390-4
Haas, M. T., Alejandro, R. E., Ratnasingam, D., & Tsao, E. Y. (2025). Pediatric cancer rehabilitation: An overview with special considerations in transitional care for adolescents and young adults and palliative rehabilitation. Physical Medicine & Rehabilitation Clinics of North America, 36(3), 603‑623. https://doi.org/10.1016/j.pmr.2025.03.007
Petrichenko, A., Bukreeva, E., Ivanova, N., Sharoev, T., Prityko, A. (2015). Cancer rehabilitation of children with solid malignant tumours. Support Care Cancer, 23 (Suppl 1): S303. https://doi.org/10.1007/s00520-015-2712-y
Rowley, D., Iniesta, R. R., Patrick, K., Massey, S., & Wright, P. (2025). Haematopoietic Stem Cell Transplantation for Children and Young People: Is There a Role for Prehabilitation? A Scoping Review. Supportive Care in Cancer, 33(12), 1149. https://doi.org/10.1007/s00520-025-09988-4
Sandblom, L., Keole, M., Winsten, C., & Stanford, R. (2024). "Prehabilitation" for pediatric patients with cancer before undergoing hematopoietic stem cell transplantation. Journal of Pediatric Hematology/Oncology, 46(3), 143-146. https://doi.org/10.1097/MPH.0000000000002847
Watts, T., Courtier, N., Fry, S., Gale, N., Gillen, E., McCutchan, G., Patil, M., Rees, T., Roche, D., Wheelwright, S., & Hopkinson, J. (2025). Access, acceptance and adherence to cancer prehabilitation: a mixed-methods systematic review. Journal of Cancer Survivorship 19, 1895-1923. https://doi.org/10.1007/s11764-024-01605-3
Yang, J., Roy, I. & Hunter, H. (2025). Prehabilitation for muscle wasting in cancer: do definitions matter? Support Care Cancer 33, 807. https://doi.org/10.1007/s00520-025-09857-0
Zacha, S., Szwed, A., Miegoń, J., Skonieczna-Żydecka, K., Andrzejewska, A., Modrzejewska, E., Horecki, M., Jarosz, K., & Biernawska, J. (2023). Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics. Journal of Personalized Medicine, 13(9), 1417. https://doi.org/10.3390/jpm13091417