Aerobic Exercise-Induced Changes in Cardiorespiratory Fitness in Breast Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-Analysis.

Guilherme Maginador,Luís O Sarian,Manoel E Lixandrão,Carlos Ugrinowitsch,Sophie Derchain,Miguel S Conceição,Guilherme D Telles,Felipe C Vechin,Eva Zopf,Henrique I Bortolozo

doi:10.3390/cancers12082240

Abstract

While performing aerobic exercise during chemotherapy has been proven feasible and safe, the efficacy of aerobic training on cardiorespiratory fitness (CRF) in women with breast cancer undergoing chemotherapy has not yet been systematically assessed. Therefore, the objective of this work was to determine (a) the efficacy of aerobic training to improve CRF; (b) the role of aerobic training intensity (moderate or vigorous) on CRF response; (c) the effect of the aerobic training mode (continuous or interval) on changes in CRF in women with breast cancer (BC) receiving chemotherapy. A systematic review and meta-analysis were conducted as per PRISMA guidelines, and randomized controlled trials comparing usual care (UC) and aerobic training in women with BC undergoing chemotherapy were eligible. The results suggest that increases in CRF are favored by (a) aerobic training when compared to usual care; (b) vigorous-intensity aerobic exercise (64–90% of maximal oxygen uptake, VO2max) when compared to moderate-intensity aerobic exercise (46–63% of VO2max); and (c) both continuous and interval aerobic training are effective at increasing the VO2max. Aerobic training improves CRF in women with BC undergoing chemotherapy. Notably, training intensity significantly impacts the VO2max response. Where appropriate, vigorous intensity aerobic training should be considered for women with BC receiving chemotherapy.

Highlights

According to the World Health Organization (WHO), cancer was the leading cause of death worldwide in 2018
22.1 ± 7.0 mL·kg−1 min−1 ) in women with breast cancer (BC) undergoing chemotherapy. These results suggest that aerobic training intensity may play a role when aiming to improve VO2max in women with BC undergoing chemotherapy
Our findings indicated that aerobic exercise increases the VO2max in women with BC

Summary

Introduction

According to the World Health Organization (WHO), cancer was the leading cause of death worldwide in 2018. Two million new cases and over 600,000 deaths were attributed to breast cancer (BC) alone [1]. Despite its positive clinical effect, chemotherapy has been associated with debilitating side effects [3], such as muscle atrophy [4,5], cancer-related fatigue [6,7,8], and cardiotoxicity [9,10,11]. BC undergoing adjuvant chemotherapy [12] This is a concern, given that emerging evidence suggests that CRF is a significant prognostic marker, with data indicating that a poor VO2max is associated with a poorer quality of life, treatment-induced cardiotoxicity, and an increased risk of cancer-related mortality [13,14,15,16]

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