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Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis

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Abstract

Background

Physical exercise in women with breast cancer has shown benefits in reducing fatigue levels during adjuvant radiotherapy and chemotherapy. However, it is not well understood which type of exercise is more effective.

Objective

Assess the impact of different types of physical exercises on fatigue and which is the most effective in reducing this adverse effect during adjuvant treatment in breast cancer.

Methods

The inclusion criteria were randomized clinical trials of physical exercise in women diagnosed with breast cancer in stages I to IV, above 18 years, evaluating fatigue using validated questionnaires. The meta-analysis pooled results by standardized mean difference (SMD).

Results

A total of 20 randomized clinical trials involving 1793 participants revealed that the practice of physical exercise was statistically effective in reducing fatigue (SMD =  − 0.46; 95% CI: − 0.66, − 0.27). Our analysis of subgroups suggests that the supervised combination of resistance training (RT) with aerobic training (AT) is the most effective physical exercise to reduce fatigue (SMD =  − 1.13; 95% CI: − 2.09, − 0.17). The supervised RT was more effective (SMD =  − 0.30; 95% CI: − 0.46, − 0.15) than supervised AT or mind–body techniques. It was observed that only during chemotherapy, women with breast cancer in the intervention groups showed a significant reduction in fatigue (SMD =  − 0.38; 95% CI: − 0.55 to − 0.20).

Conclusion

Physical exercise during adjuvant chemotherapy and/or radiotherapy in women with breast cancer can be considered beneficial in reducing fatigue, especially for women undergoing chemotherapy and for supervised training of resistance or combined RT and AT.

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Data Availability

The datasets and materials used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Authors and Affiliations

  1. National Cancer Institute - INCA, Hospital Do Câncer III, Rio de Janeiro, Brazil

    Daniele Medeiros Torres

  2. National Public Health School (ENSP, Escola Nacional de Saúde Pública), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil

    Rosalina Jorge Koifman & Sabrina da Silva Santos

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  1. Daniele Medeiros Torres
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  2. Rosalina Jorge Koifman
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Contributions

DMT searched the databases and was one of the independent reviewers through all the stages of the systematic review. SSS was one of the independent reviewers through all the stages of the systematic review. RJK was the third independent reviewer when there was a discrepancy between the two main reviewers. All authors read and approved the final manuscript.

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Correspondence to Daniele Medeiros Torres.

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Medeiros Torres, D., Jorge Koifman, R. & da Silva Santos, S. Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis. Support Care Cancer 30, 4651–4662 (2022). https://doi.org/10.1007/s00520-022-06809-w

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