

浏览全部资源
扫码关注微信
同济大学附属东方医院肿瘤科,上海 200120
Received:27 June 2025,
Revised:2025-09-23,
Published:30 October 2025
移动端阅览
Yalin LI, Yan TU, Ming QUAN. Research progress and prospects of exercise intervention in comprehensive management of colorectal cancer[J]. China Oncology, 2025, 35(10): 920-928.
Yalin LI, Yan TU, Ming QUAN. Research progress and prospects of exercise intervention in comprehensive management of colorectal cancer[J]. China Oncology, 2025, 35(10): 920-928. DOI: 10.19401/j.cnki.1007-3639.2025.10.003.
结直肠癌(colorectal cancer,CRC)是最常见的消化道恶性肿瘤,发病率逐年上升且呈年轻化趋势,给社会及家庭带来了沉重的卫生经济负担。现有证据表明,定期进行中度至高强度的运动锻炼,可显著降低CRC的发病风险,减轻并发症及抗肿瘤治疗相关不良反应,提高患者的生活质量,延长患者的生存期。运动锻炼作为一种简单经济的非药物干预手段,通过调节炎症信号、促进合成代谢等多组学调控网络,在CRC治疗及康复全程中具有重要意义。本文综述临床和实验研究的最新证据,强调运动锻炼在CRC全程管理中的作用不可或缺,并就相关机制进行了汇总分析。未来的研究应进一步分析各种运动类型、强度和频率对CRC的具体影响,并与放化疗等临床治疗手段相结合,探索多模式干预下的精准化方案,以最大化其临床效益。
Colorectal cancer (CRC) is the most common malignant tumor of the digestive tract
with its incidence rate increasing annually and showing a younger-age trend
imposing heavy health and economic burdens on society and families. Regular moderate-to-vigorous physical exercise has been demonstrated to significantly reduce the risk of developing CRC
alleviate complications and adverse reactions related to anti-tumor treatment
improve patients’ quality of life
and prolong survival. As a simple and economical non-pharmacological intervention
exercise plays a crucial role throughout CRC development and treatment by regulating inflammatory signals and promoting anabolic metabolism through multi-omics regulatory networks. This article reviewed the latest evidence from clinical and experimental studies
emphasizing the indispensability of exercise in the comprehensive management of CRC patients
and provided a summary analysis of relevant mechanisms. Future research should further investigate the specific impacts of various exercise types
intensities
and frequencies on CRC
combine them with clinical treatment methods such as radiotherapy and chemotherapy
and explore precision approaches under multimodal interventions to maximize clinical benefits.
BRAY F , LAVERSANNE M , SUNG H , et al . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 - 263 .
XU L Y , ZHAO J H , LI Z H , et al . National and subnational incidence, mortality and associated factors of colorectal cancer in China: a systematic analysis and modelling study [J ] . J Glob Health , 2023 , 13 : 04096 . DOI: 10.7189/jogh.13.04096 http://doi.org/10.7189/jogh.13.04096
UNGVARI Z , FEKETE M , VARGA P , et al . Overweight and obesity significantly increase colorectal cancer risk: a meta-analysis of 66 studies revealing a 25-57% elevation in risk [J ] . Geroscience , 2025 , 47 ( 3 ): 3343 - 3364 . DOI: 10.1007/s11357-024-01375-x http://doi.org/10.1007/s11357-024-01375-x
SUN Y , KEAT O B , RAJABI S . The role of physical activity and epigenetic changes in colorectal cancer prevention [J ] . Cancer Cell Int , 2025 , 25 ( 1 ): 227 . DOI: 10.1186/s12935-025-03872-1 http://doi.org/10.1186/s12935-025-03872-1
EKELUND U , STEENE-JOHANNESSEN J , BROWN W J , et al . Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women [J ] . Lancet , 2016 , 388 ( 10051 ): 1302 - 1310 . DOI: 10.1016/S0140-6736(16)30370-1 http://doi.org/10.1016/S0140-6736(16)30370-1
WU Y J , MENG M J , LIU Y F , et al . Physical activity, genetic susceptibility, and risk of colorectal cancer in type 2 diabetes: a large population-based cohort study [J ] . Dtsch Arztebl Int , 2025 , 122 ( 7 ): 186 - 192 .
STAMATAKIS E , AHMADI M N , GILL J M R , et al . Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality [J ] . Nat Med , 2022 , 28 ( 12 ): 2521 - 2529 . DOI: 10.1038/s41591-022-02100-x http://doi.org/10.1038/s41591-022-02100-x
STAMATAKIS E , AHMADI M N , FRIEDENREICH C M , et al . Vigorous intermittent lifestyle physical activity and cancer incidence among nonexercising adults: the UK biobank accelerometry study [J ] . JAMA Oncol , 2023 , 9 ( 9 ): 1255 - 1259 . DOI: 10.1001/jamaoncol.2023.1830 http://doi.org/10.1001/jamaoncol.2023.1830 https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734 https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734
MOORE S C , LEE I M , WEIDERPASS E , et al . Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults [J ] . JAMA Intern Med , 2016 , 176 ( 6 ): 816 - 825 . DOI: 10.1001/jamainternmed.2016.1548 http://doi.org/10.1001/jamainternmed.2016.1548
BARDOU M , BARKUN A N , MARTEL M . Obesity and colorectal cancer [J ] . Gut , 2013 , 62 ( 6 ): 933 - 947 . DOI: 10.1136/gutjnl-2013-304701 http://doi.org/10.1136/gutjnl-2013-304701
BROWN J C , MA C , SHI Q , et al . Physical activity in stage Ⅲ colon cancer: CALGB/SWOG 80702 (alliance) [J ] . J Clin Oncol , 2023 , 41 ( 2 ): 243 - 254 .
KENKHUIS M F , VAN ROEKEL E H , BREEDVELD-PETERS J J L , et al . Longitudinal associations of sedentary behavior and physical activity with quality of life in colorectal cancer survivors [J ] . Med Sci Sports Exerc , 2021 , 53 ( 11 ): 2298 - 2308 . DOI: 10.1249/MSS.0000000000002703 http://doi.org/10.1249/MSS.0000000000002703 https://journals.lww.com/10.1249/MSS.0000000000002703 https://journals.lww.com/10.1249/MSS.0000000000002703
LEE S , MA C , SHI Q , et al . Potential mediators of oxaliplatin-induced peripheral neuropathy from adjuvant therapy in stage Ⅲ colon cancer: findings from CALGB (alliance)/SWOG 80702 [J ] . J Clin Oncol , 2023 , 41 ( 5 ): 1079 - 1091 .
SINGH F , NEWTON R U , BAKER M K , et al . Feasibility and efficacy of presurgical exercise in survivors of rectal cancer scheduled to receive curative resection [J ] . Clin Colorectal Cancer , 2017 , 16 ( 4 ): 358 - 365 .
MORIELLI A R , USMANI N , BOULÉ N G , et al . Feasibility, safety, and preliminary efficacy of exercise during and after neoadjuvant rectal cancer treatment: a phase Ⅱ randomized controlled trial [J ] . Clin Colorectal Cancer , 2021 , 20 ( 3 ): 216 - 226 .
MIN J , AN K Y , PARK H , et al . Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial [J ] . BMC Gastroenterol , 2023 , 23 ( 1 ): 127 . DOI: 10.1186/s12876-023-02755-x http://doi.org/10.1186/s12876-023-02755-x
BERKEL A E M , BONGERS B C , KOTTE H , et al . Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial [J ] . Ann Surg , 2022 , 275 ( 2 ): e299 - e306 . DOI: 10.1097/SLA.0000000000004702 http://doi.org/10.1097/SLA.0000000000004702 https://journals.lww.com/10.1097/SLA.0000000000004702 https://journals.lww.com/10.1097/SLA.0000000000004702
ONERUP A , ANGENETE E , BOCK D , et al . The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial [J ] . Trials , 2017 , 18 ( 1 ): 212 . DOI: 10.1186/s13063-017-1949-9 http://doi.org/10.1186/s13063-017-1949-9
MEYERHARDT J A , HESELTINE D , NIEDZWIECKI D , et al . Impact of physical activity on cancer recurrence and survival in patients with stage Ⅲ colon cancer: findings from CALGB 89803 [J ] . J Clin Oncol , 2006 , 24 ( 22 ): 3535 - 3541 . DOI: 10.1200/JCO.2006.06.0863 http://doi.org/10.1200/JCO.2006.06.0863 https://ascopubs.org/doi/10.1200/JCO.2006.06.0863 https://ascopubs.org/doi/10.1200/JCO.2006.06.0863
VAN ROOIJEN S J , ENGELEN M A , SCHEEDE-BERGDAHL C , et al . Systematic review of exercise training in colorectal cancer patients during treatment [J ] . Scand J Med Sci Sports , 2018 , 28 ( 2 ): 360 - 370 . DOI: 10.1111/sms.2018.28.issue-2 http://doi.org/10.1111/sms.2018.28.issue-2 https://onlinelibrary.wiley.com/toc/16000838/28/2 https://onlinelibrary.wiley.com/toc/16000838/28/2
ZOPF E M , SCHULZ H , POESCHKO J , et al . Effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy-a pilot study [J ] . Support Care Cancer , 2022 , 30 ( 3 ): 1945 - 1955 .
MUSTIAN K M , ALFANO C M , HECKLER C , et al . Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis [J ] . JAMA Oncol , 2017 , 3 ( 7 ): 961 - 968 . DOI: 10.1001/jamaoncol.2016.6914 http://doi.org/10.1001/jamaoncol.2016.6914
LIU D , WU X Y , JIANG X Y . Effects of moderate-to-vigorous physical activity on cancer-related fatigue in patients with colorectal cancer: a systematic review and meta-analysis [J ] . Arch Med Res , 2020 , 51 ( 2 ): 173 - 179 . DOI: S0188-4409(19)30564-8 http://doi.org/S0188-4409(19)30564-8
GORDON B R , MCDOWELL C P , HALLGREN M , et al . Association of efficacy of resistance exercise training with depressive symptoms: meta-analysis and meta-regression analysis of randomized clinical trials [J ] . JAMA Psychiatry , 2018 , 75 ( 6 ): 566 - 576 . DOI: 10.1001/jamapsychiatry.2018.0572 http://doi.org/10.1001/jamapsychiatry.2018.0572
DEVIN J L , JENKINS D G , SAX A T , et al . Cardiorespiratory fitness and body composition responses to different intensities and frequencies of exercise training in colorectal cancer survivors [J ] . Clin Colorectal Cancer , 2018 , 17 ( 2 ): e269 - e279 .
LEAL L G , LOPES M A , PERES S B , et al . Exercise training as therapeutic approach in cancer cachexia: a review of potential anti-inflammatory effect on muscle wasting [J ] . Front Physiol , 2020 , 11 : 570170 . DOI: 10.3389/fphys.2020.570170 http://doi.org/10.3389/fphys.2020.570170 https://www.frontiersin.org/articles/10.3389/fphys.2020.570170/full https://www.frontiersin.org/articles/10.3389/fphys.2020.570170/full
HOJMAN P , FJELBYE J , ZERAHN B , et al . Voluntary exercise prevents cisplatin-induced muscle wasting during chemotherapy in mice [J ] . PLoS One , 2014 , 9 ( 9 ): e109030 . DOI: 10.1371/journal.pone.0109030 http://doi.org/10.1371/journal.pone.0109030 https://dx.plos.org/10.1371/journal.pone.0109030 https://dx.plos.org/10.1371/journal.pone.0109030
李政佳 , 赵文晓 , 赵军 , 等 . 不同身心运动疗法对癌症患者癌因性疲乏及健康相关结局影响的网状Meta分析 [J/OL ] . 护士进修杂志 . https://link.cnki.net/urlid/52.1063.r.20250418.1609.004 https://link.cnki.net/urlid/52.1063.r.20250418.1609.004 https://link.cnki.net/urlid/52.1063.r.20250418.1609.004.
LI Z J , ZHAO W X , ZHAO J , et al . Different mind-body exercise on cancer-related fatigue and health-related outcomes in patients with cancer: a systematic review and network meta-analysis [J/OL ] . J Nurses Training . https://link.cnki.net/urlid/52.1063.r.20250418.1609.004 https://link.cnki.net/urlid/52.1063.r.20250418.1609.004 https://link.cnki.net/urlid/52.1063.r.20250418.1609.004.
BROUWER C G , TEN TUSSCHER M R , DE ROOS B M , et al . Experiences of patients with metastatic colorectal cancer participating in a supervised exercise intervention during chemotherapy [J ] . Support Care Cancer , 2025 , 33 ( 2 ): 82 . DOI: 10.1007/s00520-024-09101-1 http://doi.org/10.1007/s00520-024-09101-1
NEWTON R U , GALVÃO D A . Exercise in prevention and management of cancer [J ] . Curr Treat Options Oncol , 2008 , 9 ( 2/3 ): 135 - 146 . DOI: 10.1007/s11864-008-0065-1 http://doi.org/10.1007/s11864-008-0065-1 http://link.springer.com/10.1007/s11864-008-0065-1 http://link.springer.com/10.1007/s11864-008-0065-1
ZHU C M , MA H B , HE A Q , et al . Exercise in cancer prevention and anticancer therapy: efficacy, molecular mechanisms and clinical information [J ] . Cancer Lett , 2022 , 544 : 215814 . DOI: 10.1016/j.canlet.2022.215814 http://doi.org/10.1016/j.canlet.2022.215814 https://linkinghub.elsevier.com/retrieve/pii/S0304383522002981 https://linkinghub.elsevier.com/retrieve/pii/S0304383522002981
COURNEYA K S , VARDY J L , O’CALLAGHAN C J , et al . Structured exercise after adjuvant chemotherapy for colon cancer [J ] . N Engl J Med , 2025 , 393 ( 1 ): 13 - 25 . DOI: 10.1056/NEJMoa2502760 http://doi.org/10.1056/NEJMoa2502760 http://www.nejm.org/doi/10.1056/NEJMoa2502760 http://www.nejm.org/doi/10.1056/NEJMoa2502760
SAX A T , JENKINS D G , DEVIN J L , et al . The insulin-like growth factor axis: a biological mechanism linking physical activity to colorectal cancer survival [J ] . Cancer Epidemiol , 2014 , 38 ( 4 ): 455 - 459 . DOI: 10.1016/j.canep.2014.05.011 http://doi.org/10.1016/j.canep.2014.05.011
ZHANG D Q , LU C F , SANG K . Exercise as a metabolic regulator: targeting AMPK/mTOR-autophagy crosstalk to counteract sarcopenic obesity [J ] . Aging Dis , 2025 .
NISHIHARA K , NAKANO S , YAMAJI T , et al . Height, body mass index, physical activity, and risk of colorectal cancer in relation to expression of insulin receptor: the Japan Public Health Center-based prospective study [J ] . Int J Cancer , 2024 , 155 ( 10 ): 1751 - 1761 . DOI: 10.1002/ijc.35075 http://doi.org/10.1002/ijc.35075
CHANG P H , PAN Y P , FAN C W , et al . Pretreatment serum interleukin-1β, interleukin-6, and tumor necrosis factor-α levels predict the progression of colorectal cancer [J ] . Cancer Med , 2016 , 5 ( 3 ): 426 - 433 . DOI: 10.1002/cam4.2016.5.issue-3 http://doi.org/10.1002/cam4.2016.5.issue-3 https://onlinelibrary.wiley.com/toc/20457634/5/3 https://onlinelibrary.wiley.com/toc/20457634/5/3
PHILIPPE M , KRÜSMANN P J , MERSA L , et al . Acute effects of concentric and eccentric exercise on glucose metabolism and interleukin-6 concentration in healthy males [J ] . Biol Sport , 2016 , 33 ( 2 ): 153 - 158 . DOI: 10.5604/20831862.1198634 http://doi.org/10.5604/20831862.1198634
IDORN M , THOR STRATEN P . Exercise and cancer: from “healthy” to “therapeutic” [J ] . Cancer Immunol Immunother , 2017 , 66 ( 5 ): 667 - 671 . DOI: 10.1007/s00262-017-1985-z http://doi.org/10.1007/s00262-017-1985-z http://link.springer.com/10.1007/s00262-017-1985-z http://link.springer.com/10.1007/s00262-017-1985-z
DEVIN J L , HILL M M , MOURTZAKIS M , et al . Acute high intensity interval exercise reduces colon cancer cell growth [J ] . J Physiol , 2019 , 597 ( 8 ): 2177 - 2184 . DOI: 10.1113/tjp.2019.597.issue-8 http://doi.org/10.1113/tjp.2019.597.issue-8 https://physoc.onlinelibrary.wiley.com/toc/14697793/597/8 https://physoc.onlinelibrary.wiley.com/toc/14697793/597/8
GHAZIZADEH DARBAND S , SABOORY E , SADIGHPARVAR S , et al . The modulatory effects of exercise on the inflammatory and apoptotic markers in rats with 1, 2-dimethylhydrazine-induced colorectal cancer [J ] . Can J Physiol Pharmacol , 2020 , 98 ( 3 ): 147 - 155 . DOI: 10.1139/cjpp-2019-0329 http://doi.org/10.1139/cjpp-2019-0329 https://cdnsciencepub.com/doi/10.1139/cjpp-2019-0329 https://cdnsciencepub.com/doi/10.1139/cjpp-2019-0329
RENMAN D , GYLLING B , VIDMAN L , et al . Density of CD3 + and CD8 + cells in the microenvironment of colorectal cancer according to prediagnostic physical activity [J ] . Cancer Epidemiol Biomark Prev , 2021 , 30 ( 12 ): 2317 - 2326 . DOI: 10.1158/1055-9965.EPI-21-0508 http://doi.org/10.1158/1055-9965.EPI-21-0508 https://aacrjournals.org/cebp/article/30/12/2317/674938/Density-of-CD3-and-CD8-Cells-in-the https://aacrjournals.org/cebp/article/30/12/2317/674938/Density-of-CD3-and-CD8-Cells-in-the
HATFIELD S M , KJAERGAARD J , LUKASHEV D , et al . Immunological mechanisms of the antitumor effects of supplemental oxygenation [J ] . Sci Transl Med , 2015 , 7 ( 277 ): 277ra30 .
ZHAO Z H , YAN K , GUAN Q , et al . Mechanism and physical activities in bone-skeletal muscle crosstalk [J ] . Front Endocrinol , 2023 , 14 : 1287972 . DOI: 10.3389/fendo.2023.1287972 http://doi.org/10.3389/fendo.2023.1287972 https://www.frontiersin.org/articles/10.3389/fendo.2023.1287972/full https://www.frontiersin.org/articles/10.3389/fendo.2023.1287972/full
SHIM Y J , KIM H J , OH S C , et al . Exercise during adjuvant treatment for colorectal cancer: treatment completion, treatment-related toxicities, body composition, and serum level of adipokines [J ] . Cancer Manag Res , 2019 , 11 : 5403 - 5412 . DOI: 10.2147/CMAR.S208754 http://doi.org/10.2147/CMAR.S208754
SI H F , YANG Q , HU H , et al . Colorectal cancer occurrence and treatment based on changes in intestinal flora [J ] . Semin Cancer Biol , 2021 , 70 : 3 - 10 . DOI: 10.1016/j.semcancer.2020.05.004 http://doi.org/10.1016/j.semcancer.2020.05.004
SPAANDER M C W , ZAUBER A G , SYNGAL S , et al . Young-onset colorectal cancer [J ] . Nat Rev Dis Primers , 2023 , 9 : 21 . DOI: 10.1038/s41572-023-00432-7 http://doi.org/10.1038/s41572-023-00432-7
TELLES G D , LIBARDI C A , CONCEIÇÃO M S , et al . Interrelated but not time-aligned response in myogenic regulatory factors demethylation and mRNA expression after divergent exercise bouts [J ] . Med Sci Sports Exerc , 2023 , 55 ( 2 ): 199 - 208 .
VOISIN S , EYNON N , YAN X , et al . Exercise training and DNA methylation in humans [J ] . Acta Physiol , 2015 , 213 ( 1 ): 39 - 59 . DOI: 10.1111/apha.2014.213.issue-1 http://doi.org/10.1111/apha.2014.213.issue-1 https://onlinelibrary.wiley.com/toc/17481716/213/1 https://onlinelibrary.wiley.com/toc/17481716/213/1
LASKAR R S , QU C , HUYGHE J R , et al . Genome-wide association studies and Mendelian randomization analyses provide insights into the causes of early-onset colorectal cancer [J ] . Ann Oncol , 2024 , 35 ( 6 ): 523 - 536 . DOI: 10.1016/j.annonc.2024.02.008 http://doi.org/10.1016/j.annonc.2024.02.008 https://linkinghub.elsevier.com/retrieve/pii/S0923753424000589 https://linkinghub.elsevier.com/retrieve/pii/S0923753424000589
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621