Efektivitas Prehabilitasi Multimodal (Latihan Fisik, Nutrisi, Dan Dukungan Psikologis) Terhadap Tingkat Toleransi Kemoterapi Dan Kualitas Hidup Pasien Kanker: Systematic Review
DOI:
https://doi.org/10.31004/koloni.v5i3.1482Keywords:
Cancer, Chemotherapy, Quality of Life, Prehabilitation, Treatment ToleranceAbstract
Chemotherapy is a crucial component of cancer management; however, it can lead to toxicity, fatigue, reduced physical function, nutritional deficiencies, and psychological issues that impact both treatment tolerance and patient quality of life. To enhance patient readiness prior to therapy, multimodal prehabilitation—encompassing physical activity, nutritional therapy, and psychological support—has been developed. This study aims to evaluate the impact of multimodal prehabilitation on the quality of life and chemotherapy tolerance of cancer patients. A systematic review design based on PRISMA guidelines was employed. Literature sources covering the period from 2021 to 2026 were retrieved from PubMed/MEDLINE, Scopus, ScienceDirect, Web of Science, and Google Scholar. The study sample consisted of publications meeting specific inclusion criteria: cancer patients undergoing prehabilitation prior to or during neoadjuvant therapy (involving physical activity, nutrition, and/or psychological support) with reported outcomes regarding treatment tolerance and quality of life. Articles were selected using a purposive sampling method. Following data extraction based on study characteristics, interventions, and outcomes, descriptive and narrative analyses were conducted. The research indicates that multimodal prehabilitation tends to improve or maintain muscle mass, cardiorespiratory fitness, functional capacity, and other aspects of quality of life. Furthermore, several trials demonstrated reduced toxicity or complications and higher treatment completion rates. However, due to variations in cancer types, treatment plans, intervention timing, and outcome measures, the impact on chemotherapy tolerance remains inconsistent. Multimodal prehabilitation can assist cancer patients in tolerating therapy while improving their quality of life and physical and psychological readiness. Further research utilizing more standardized designs and outcome measures is required to validate its efficacy regarding chemotherapy tolerance.
References
Allen, S. K., Brown, V., White, D., King, D., Hunt, J., Wainwright, J., Emery, A., Hodge, E., Kehinde, A., Prabhu, P., Rockall, T. A., Preston, S. R. and Sultan, J. (2022) ‘Multimodal prehabilitation during neoadjuvant therapy prior to esophagogastric cancer resection: Effect on cardiopulmonary exercise test performance, muscle mass and quality of life—A pilot randomized clinical trial’, Annals of Surgical Oncology, 29(3), pp. 1839–1850. https://doi.org/10.1245/s10434-021-11002-0.
Anand, U., Dey, A., Chandel, A. K. S., Sanyal, R., Mishra, A., Pandey, D. K., De Falco, V., Upadhyay, A., Kandimalla, R., Chaudhary, A., Dhanjal, J. K., Dewanjee, S., Vallamkondu, J. and Pérez de la Lastra, J. M. (2022) ‘Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics’, Genes & Diseases, 10(4), pp. 1367–1401. https://doi.org/10.1016/j.gendis.2022.02.007.
Argudo, N., Rodó-Pin, A., Martínez-Llorens, J., Marco, E., Visa, L., Messaggi-Sartor, M., Balañá-Corberó, A., Ramón, J. M., Rodríguez-Chiaradía, D. A., Grande, L. and Pera, M. (2021) ‘Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: An interventional pilot study’, Diseases of the Esophagus, 34(4), doaa086. https://doi.org/10.1093/dote/doaa086.
Asmare, T. B., Tadesse, M. A., Gobezie, N. Z., Deress, G. M., Admassie, B. M., Demissie, B., Abate, A. T., Mekuriaw, B. Y., Gedefaw, G. D. and Wubet, H. B. (2026) ‘Prehabilitation in older adults with cancer: Scoping review of surgical outcomes’, BMJ Supportive & Palliative Care, 16(4), pp. 765–777. https://doi.org/10.1136/spcare-2026-006166.
Bausys, A., Luksta, M., Anglickiene, G., Maneikiene, V. V., Kryzauskas, M., Rybakovas, A., Dulskas, A., Kuliavas, J., Stratilatovas, E., Macijauskiene, L., Simbelyte, T., Celutkiene, J., Jamontaite, I. E., Cirtautas, A., Lenickiene, S., Petrauskiene, D., Cikanaviciute, E., Gaveliene, E., Klimaviciute, G., Rauduvyte, K. et al. (2023) ‘Effect of home-based prehabilitation on postoperative complications after surgery for gastric cancer: Randomized clinical trial’, British Journal of Surgery, 110(12), pp. 1800–1807. https://doi.org/10.1093/bjs/znad312.
Casanovas-Álvarez, A., Estanyol, B., Ciendones, M., Padròs, J., Cuartero, J., Barnadas, A., García-Valdecasas, B., González-Colom, R., Sebio-García, R. and Masià, J. (2024) ‘Effectiveness of an exercise and educational-based prehabilitation program in patients with breast cancer receiving neoadjuvant chemotherapy (PREOptimize) on functional outcomes: A randomized controlled trial’, Physical Therapy, 104(12), pzae151. https://doi.org/10.1093/ptj/pzae151.
Cerrone, V., Capasso, R., Cascella, M., Rubbi, I., Gisi, A. D., Di Santo, P. and Andretta, V. (2026) ‘Measurement instruments used to assess caregiver burden in informal caregivers of adult cancer patients: A systematic review’, Nursing Reports, 16(5), p. 172. https://doi.org/10.3390/nursrep16050172.
Cheng, Y., Liu, Y., Ma, J., Li, Z., Han, E. and Bo, S. (2025) ‘Effects of three aerobic exercise modalities (walking, running, and cycling) on circulating brain-derived neurotrophic factor in older adults: A systematic review and meta-analysis’, Frontiers in Aging Neuroscience, 17, 1673786. https://doi.org/10.3389/fnagi.2025.1673786.
Cho, A. R., Vongchaiudomchoke, W., Balde, D., Kim, D. J. and Carli, F. (2025) ‘Enhancing postoperative recovery with multimodal prehabilitation: The journey begins before surgery’, Korean Journal of Anesthesiology, 78(5), pp. 401–417. https://doi.org/10.4097/kja.25320.
Debela, D. T., Muzazu, S. G., Heraro, K. D., Ndalama, M. T., Mesele, B. W., Haile, D. C., Kitui, S. K. and Manyazewal, T. (2021) ‘New approaches and procedures for cancer treatment: Current perspectives’, SAGE Open Medicine, 9, 20503121211034366. https://doi.org/10.1177/20503121211034366.
Doré, I., Piché, A., Montiel, C., Lambert, S. D., Gillis, C., Dufresne, S. S., Riesco, E., Jardel, P., Pavic, M., Samouélian, V., Dubé, S., Brisson, I. and Charpentier, D. (2025) ‘Multimodal group-based tele-prehabilitation for cancer patients and caregivers: A pragmatic multicentre hybrid implementation-effectiveness study protocol’, Frontiers in Oncology, 15, 1566489. https://doi.org/10.3389/fonc.2025.1566489.
Hoad, K. L., Ton, C., Williamson, D., Subar, D. A., Nuttall, H. E. and Gaffney, C. J. (2026) ‘The role of prehabilitation in improving brain health and cognition after chemotherapy in patients with colorectal cancer: Study protocol of the Chemo Brain Prehab Project’, PLOS ONE, 21(3), e0341996. https://doi.org/10.1371/journal.pone.0341996.
Jang, M. K., Park, S., Jeon, J. Y., Kang, M. J., Park, C., Doorenbos, A. Z. and Kim, S. (2025) ‘Evaluating the effects of a resistance exercise intervention for sarcopenia in patients receiving neoadjuvant chemotherapy for breast cancer: Study protocol for a randomized controlled trial’, BMC Cancer, 25(1), p. 1296. https://doi.org/10.1186/s12885-025-14721-9.
Kjeldsted, E., Ammitzbøll, G., Jørgensen, L. B., Lodin, A., Bojesen, R. D., Ceballos, S. G., Rosthøj, S., Lænkholm, A. V., Skou, S. T., Jack, S., Gehl, J. and Dalton, S. O. (2023) ‘Neo-train: Study protocol and feasibility results for a two-arm randomized controlled trial investigating the effect of supervised exercise during neoadjuvant chemotherapy on tumour response in patients with breast cancer’, BMC Cancer, 23(1), p. 777. https://doi.org/10.1186/s12885-023-11284-5.
Klek, S., Laviano, A., Chrostek, H. et al. (2025) ‘Nutrition in oncology: Overcoming challenges to optimize the patient journey from prehabilitation to rehabilitation’, Oncology and Therapy, 13, pp. 577–593. https://doi.org/10.1007/s40487-025-00358-y.
Kwan, D., Kwan, W., Badwal, A., Puol, T., Deng, J. Z., Wang, R., Ahmed, S., Mansfield, A., Fazelzad, R. and Jones, J. (2026) ‘Prehabilitation in adult cancer patients undergoing chemotherapy or radiotherapy: A scoping review’, Cancers, 18(2), p. 286. https://doi.org/10.3390/cancers18020286.
Li, D., Lv, Y., Wang, R., Li, J., Zhang, Y., Rong, Y., Li, X. and Gao, L. (2026) ‘Effects of prehabilitation on outcomes among patients undergoing surgery for lung cancer: A systematic review and meta-analysis of randomized controlled trials’, Journal of Thoracic Disease, 18(6), p. 656. https://doi.org/10.21037/jtd-2026-0694.
López-González, M., Álvarez-Bueno, C., Rodríguez-Martín, B., Lorenzo-García, P., Ruiz-Grao, M. C. and Priego-Jiménez, S. (2025) ‘Effect of prehabilitation on the 6-minute walk test and length of hospital stay in frail older people: A meta-analysis of randomized controlled trials’, International Journal of Environmental Research and Public Health, 22(9), p. 1381. https://doi.org/10.3390/ijerph22091381.
Loughney, L., Bolger, J., Tully, R., Sorensen, J., Bambrick, M., Carroll, P. A., Arumugasamy, M., Murphy, T. J., McCaffrey, N., Robb, W. B. and PERIOP-OG Working Group (2024) ‘The effect of a pre-operative and post-operative exercise programme versus standard care on physical fitness of patients with oesophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (the PERIOP-OG trial): A randomized controlled trial’, International Journal of Surgery, 110(10), pp. 6632–6646. https://doi.org/10.1097/JS9.0000000000001663.
Mast, I. H., Gootjes, E. C., Rütten, H., den Hartogh, M. D., Brouwer, C. G., Nagtegaal, I. D., van der Post, R. S., Hopman, M. T. E., van den Heuvel, B., Rosman, C., de Wilt, J. H. W., Klarenbeek, B. R. and Buffart, L. M. (2025) ‘Feasibility and clinical potential of exercise interventions during neoadjuvant chemoradiotherapy in patients with esophageal and rectal cancer’, Journal of Sport and Health Science, 14, 101060. https://doi.org/10.1016/j.jshs.2025.101060.
Mohamed, M. R., Rich, D. Q., Seplaki, C., Lund, J. L., Flannery, M., Culakova, E., Magnuson, A., Wells, M., Tylock, R. and Mohile, S. G. (2024) ‘Primary treatment modification and treatment tolerability among older chemotherapy recipients with advanced cancer’, JAMA Network Open, 7(2), e2356106. https://doi.org/10.1001/jamanetworkopen.2023.56106.
Moore, M., Northey, J. M., Crispin, P., Semple, S. and Toohey, K. (2023) ‘Effects of exercise rehabilitation on physical function in adults with hematological cancer receiving active treatment: A systematic review and meta-analysis’, Seminars in Oncology Nursing, 39(6), 151504. https://doi.org/10.1016/j.soncn.2023.151504.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A. et al. (2021) ‘The PRISMA 2020 statement: An updated guideline for reporting systematic reviews’, PLoS Medicine, 18(3), e1003583. https://doi.org/10.1371/journal.pmed.1003583.
Parker, N. H., Gorzelitz, J., Ngo-Huang, A., Caan, B. J., Prakash, L., Garg, N., Petzel, M. Q. B., Schadler, K., Basen-Engquist, K. and Katz, M. H. G. (2021) ‘The role of home-based exercise in maintaining skeletal muscle during preoperative pancreatic cancer treatment’, Integrative Cancer Therapies, 20, 1534735420986615. https://doi.org/10.1177/1534735420986615.
Pecorelli, N., Fermi, F., Abati, M., Bonomi, B., Fossati, L., Corti, G., Guarneri, G., Macchini, M., Damascelli, A., Palumbo, D., Gaviraghi, S., Di Mattei, V., De Cobelli, F., Tettamanti, A. and Falconi, M. (2026) ‘Multimodal prehabilitation in pancreatic cancer patients undergoing surgery (PIPS): Study protocol for a randomized controlled trial’, Trials, 27(1), p. 184. https://doi.org/10.1186/s13063-026-09467-z.
Pietrakiewicz, K., Stec, R. and Sobocki, J. (2025) ‘Prehabilitation prior to chemotherapy in humans: A review of current evidence and future directions’, Cancers, 17(16), p. 2670. https://doi.org/10.3390/cancers17162670.
Prema, S. S., Ganapathy, D. and Shanmugamprema, D. (2025) ‘Prehabilitation strategies: Enhancing surgical resilience with a focus on nutritional optimization and multimodal interventions’, Advances in Nutrition, 16(4), 100392. https://doi.org/10.1016/j.advnut.2025.100392.
Rimmer, B., Brown, M. C., Sotire, T., Beyer, F., Bolnykh, I., Balla, M., Richmond, C., Dutton, L., Williams, S., Araújo-Soares, V., Finch, T., Gallagher, P., Lewis, J., Burns, R. and Sharp, L. (2024) ‘Characteristics and components of self-management interventions for improving quality of life in cancer survivors: A systematic review’, Cancers, 16(1), p. 14. https://doi.org/10.3390/cancers16010014.
Rossi, C., Maggiore, C., Rossi, M. M., Filippone, A., Guarino, D., Di Micco, A., Forcina, L. and Magno, S. (2021) ‘A model of an integrative approach to breast cancer patients’, Integrative Cancer Therapies, 20, 15347354211040826. https://doi.org/10.1177/15347354211040826.
St-Pierre, J., Coca-Martinez, M., Drummond, K., Minnella, E., Ramanakumar, A. V., Ferri, L., Carli, F. and Scheede-Bergdahl, C. (2024) ‘Multimodal prehabilitation to enhance functional capacity of patients with esophageal cancer during concurrent neoadjuvant chemotherapies—A randomized feasibility trial’, Diseases of the Esophagus, 37(12), doae087. https://doi.org/10.1093/dote/doae087.
Sun, Y., Tian, Y., Cao, S., Li, L., Yu, W., Ding, Y., Wang, X., Kong, Y., Wang, X., Wang, H., Hui, X., Qu, J., Wang, H., Duan, Q., Yang, D., Zhang, H., Zhou, S., Liu, X., Li, Z., Liu, Q. et al. (2026) ‘Supervised multimodal prehabilitation and clinical outcomes in older patients with frailty and gastric cancer: The GISSG+2201 randomized clinical trial’, JAMA Surgery, 161(3), pp. 223–233. https://doi.org/10.1001/jamasurg.2025.6256.
Toyama, S., Morishita, T., Hanada, M., Nagura, H., Suyama, K., Yoshinaga, R., Makimoto, N., Kobayashi, S., Kanetaka, K., Murakami, S., Sato, S., Ishimatsu, Y., Tanaka, T. and Kozu, R. (2026) ‘Prehabilitation during oesophageal cancer neoadjuvant chemotherapy and postoperative functional exercise capacity’, BMJ Supportive & Palliative Care, 16(2), pp. 407–416. https://doi.org/10.1136/spcare-2025-005928.
Van Koeveringe, J. M., van Afferen, L., Drager, L. D. et al. (2026) ‘Lifestyle perceptions following multimodal prehabilitation in patients undergoing cancer surgery: A qualitative study’, Supportive Care in Cancer, 34, p. 45. https://doi.org/10.1007/s00520-026-10661-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Satria Fadhil Ardika
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
