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Exercise training benefits health-related quality of life and functional capacity during breast cancer chemotherapy: an RCT
Antunes P, Joaquim A, Sampaio F, Nunes C, Ascensao A, Vilela E, Teixeira M, Oliveira J, Capela A, Amarelo A, Leao I, Marques C, Viamonte S, Alves A, Esteves D
Medicine and Science in Sports and Exercise 2024 Apr;56(4):600-611
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To examine the effectiveness of a supervised exercise training program (SETP) on health-related quality of life (HRQoL) and functional capacity in women with breast cancer (BC) undergoing chemotherapy. METHODS: Ninety-three women with early-stage BC were randomly allocated to a SETP plus usual care (Exercise, n = 47) or usual care alone (UC, n = 46). The SETP included 3 sessions per week, combining aerobic and resistance training, conducted concurrently over the chemotherapy. The EORTC Cancer Quality-of-Life-Questionnaire-Core-30 (QLQ-C30) and the BC-specific module (QLQ-BR23) were used to assess HRQoL. Functional capacity was analyzed by maximum voluntary handgrip strength (MVHS) and by the 30-second chair sit-to-stand test (30 s CST). These endpoints were assessed at baseline (t0); middle (t1; after 8 or 12 weeks of t0); and at the end of chemotherapy (t2; after 20 weeks of t0). Mean changes from baseline were assessed by an intention-to-treat approach. RESULTS: Mixed linear model analyses showed that Exercise group experienced less deterioration in several domains of QLQ-C30 at t2, including in global health status/QoL (delta = 9.39 units; p = 0.034), QLQ-C30 summary score (delta = 8.08 units; p < 0.001), physical (delta = 15.14 units; p < 0.001), role (delta = 21.81 units; p < 0.001), cognitive (delta = 9.16 units; p = 0.032) and social functioning (delta = 11.67 units; p = 0.038), compared to the UC group. Similarly, Exercise group exhibited significant lower levels of fatigue (delta = -20.19 units; p < 0.001) and appetite loss (delta = -13.69 units; p = 0.034), compared to the UC group. Significant between-group differences were observed on MVHS of the tumor/surgery upper limb side (delta = 2.64 kg; p < 0.001) and contralateral limb (delta = 2.22 kg; p < 0.001), and on the 30-s CST score (delta = 3.56 repetitions; p < 0.001), favoring the Exercise group. No differences were observed on QLQ-BR23 domains. CONCLUSIONS: Exercise training was an effective complementary therapy to prevent the deterioration of HRQoL and functional capacity during chemotherapy in women with early-stage BC.

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