Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis

Introduction: Physical activity, as a promising complementary therapy, has shown considerable potential for reducing chemotherapy-related cardiotoxicity (CTRCT) and enhancing cardiorespiratory function (CRF). This study aimed to systematically assess the effects of physical activity on CTRCT and CRF...

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Main Authors: Kang Chen MS, Hui Guan MS, Meixia Sun MS, Yukun Zhang MS, Wenwen Zhong MS, Xiaonan Guo MS, Anqi Zuo MS, He Zhuang PhD
Format: Article
Language:English
Published: SAGE Publishing 2024-10-01
Series:Integrative Cancer Therapies
Online Access:https://doi.org/10.1177/15347354241291176
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author Kang Chen MS
Hui Guan MS
Meixia Sun MS
Yukun Zhang MS
Wenwen Zhong MS
Xiaonan Guo MS
Anqi Zuo MS
He Zhuang PhD
author_facet Kang Chen MS
Hui Guan MS
Meixia Sun MS
Yukun Zhang MS
Wenwen Zhong MS
Xiaonan Guo MS
Anqi Zuo MS
He Zhuang PhD
author_sort Kang Chen MS
collection DOAJ
description Introduction: Physical activity, as a promising complementary therapy, has shown considerable potential for reducing chemotherapy-related cardiotoxicity (CTRCT) and enhancing cardiorespiratory function (CRF). This study aimed to systematically assess the effects of physical activity on CTRCT and CRF in various cancer survivors receiving chemotherapy. Methods: A systematic review and meta-analysis was conducted. A literature search was conducted across 8 databases from inception to January 2024 and was limited to the English and Chinese languages. Statistical analysis was conducted using RevMan 5.3 and Stata 17.0 software. Results: Sixteen randomized controlled trials (RCTs) were included in the systematic review and 15 RCTs were included in the meta-analysis. Among various cancer survivors undergoing chemotherapy, physical activity markedly increased absolute oxygen uptake (VO2peak or VO2max; WMD = 292.99, 95% confidence interval [CI]:87.87 to 498.12, P  = .005), with significant effects of subgroup analysis at 4 to 10 weeks ( P  = .02) or over 16 weeks ( P  < .01), moderate-to-high or high intensity training (both P  < .0001), patients with breast cancer ( P  = .009) and reported CTRCT ( P  = .007); relative VO2peak or VO2max(WMD = 3.30, 95%CI: 2.02 to 4.58, P  < .00001), with significant effects of subgroup analysis at 10 to 16 weeks or over 16 weeks, moderate-to-high or high intensity training, patients with breast cancer, with or without reported CTRCT and exercise during chemotherapy (all P  < .01); E/A values (WMD = 0.11, 95%CI:0.03 to 0.18, P  = .007) and flow-mediated dilatation (WMD = 2.71, 95%CI:1.49 to 3.94, P  < .0001). Compared to the control group, physical activity had no significant improvement in E/e’ values ( P  = .50), NT-proBNP ( P  = .12), hs-cTn ( P  = 3.83), left ventricular ejection fraction (WMD = 2.89, 95%CI: −3.28 to 9.06, P  = .36) with non-significant effects being independent of exercise intensity or duration, with or without CTRCT and cancer types (all P  > .05), and global longitudinal strain (WMD = 0.37, 95%CI: −0.20 to 0.94, P  = .20) with non-significant effects being independent of exercise duration and cancer types(both P  > .05). Conclusions: Physical activity may be an effective complementary therapy to improve CRF and CTRCT in various cancer survivors, particularly during medium to long duration and moderate-to-high and high intensity exercise with concurrent chemotherapy.
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spelling doaj-art-b2b08e42e6054ba9aad91f325eb7e0ee2025-08-20T01:47:57ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2024-10-012310.1177/15347354241291176Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-AnalysisKang Chen MS0Hui Guan MS1Meixia Sun MS2Yukun Zhang MS3Wenwen Zhong MS4Xiaonan Guo MS5Anqi Zuo MS6He Zhuang PhD7Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaIntroduction: Physical activity, as a promising complementary therapy, has shown considerable potential for reducing chemotherapy-related cardiotoxicity (CTRCT) and enhancing cardiorespiratory function (CRF). This study aimed to systematically assess the effects of physical activity on CTRCT and CRF in various cancer survivors receiving chemotherapy. Methods: A systematic review and meta-analysis was conducted. A literature search was conducted across 8 databases from inception to January 2024 and was limited to the English and Chinese languages. Statistical analysis was conducted using RevMan 5.3 and Stata 17.0 software. Results: Sixteen randomized controlled trials (RCTs) were included in the systematic review and 15 RCTs were included in the meta-analysis. Among various cancer survivors undergoing chemotherapy, physical activity markedly increased absolute oxygen uptake (VO2peak or VO2max; WMD = 292.99, 95% confidence interval [CI]:87.87 to 498.12, P  = .005), with significant effects of subgroup analysis at 4 to 10 weeks ( P  = .02) or over 16 weeks ( P  < .01), moderate-to-high or high intensity training (both P  < .0001), patients with breast cancer ( P  = .009) and reported CTRCT ( P  = .007); relative VO2peak or VO2max(WMD = 3.30, 95%CI: 2.02 to 4.58, P  < .00001), with significant effects of subgroup analysis at 10 to 16 weeks or over 16 weeks, moderate-to-high or high intensity training, patients with breast cancer, with or without reported CTRCT and exercise during chemotherapy (all P  < .01); E/A values (WMD = 0.11, 95%CI:0.03 to 0.18, P  = .007) and flow-mediated dilatation (WMD = 2.71, 95%CI:1.49 to 3.94, P  < .0001). Compared to the control group, physical activity had no significant improvement in E/e’ values ( P  = .50), NT-proBNP ( P  = .12), hs-cTn ( P  = 3.83), left ventricular ejection fraction (WMD = 2.89, 95%CI: −3.28 to 9.06, P  = .36) with non-significant effects being independent of exercise intensity or duration, with or without CTRCT and cancer types (all P  > .05), and global longitudinal strain (WMD = 0.37, 95%CI: −0.20 to 0.94, P  = .20) with non-significant effects being independent of exercise duration and cancer types(both P  > .05). Conclusions: Physical activity may be an effective complementary therapy to improve CRF and CTRCT in various cancer survivors, particularly during medium to long duration and moderate-to-high and high intensity exercise with concurrent chemotherapy.https://doi.org/10.1177/15347354241291176
spellingShingle Kang Chen MS
Hui Guan MS
Meixia Sun MS
Yukun Zhang MS
Wenwen Zhong MS
Xiaonan Guo MS
Anqi Zuo MS
He Zhuang PhD
Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
Integrative Cancer Therapies
title Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
title_full Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
title_fullStr Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
title_full_unstemmed Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
title_short Effects of Physical Activity on Cardiotoxicity and Cardio respiratory Function in Cancer Survivors Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
title_sort effects of physical activity on cardiotoxicity and cardio respiratory function in cancer survivors undergoing chemotherapy a systematic review and meta analysis
url https://doi.org/10.1177/15347354241291176
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