Abstract
BackgroundCancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors. Approximately 40% to 80% of cancer patients undergoing active treatment suffer from CRF. Exercise improves overall quality of life and CRF; however, the specific effects of the training modalities are not well understood.MethodsThis study aimed to determine the pooled effects of supervised exercise interventions on CRF in breast cancer survivors. We searched PubMed/MEDLINE, EMBASE, Scopus, CENTRAL and CINAHL databases between December 2013 and January 2014 without language restrictions. Risk of bias and methodological quality were evaluated using the PEDro score. Pooled effects were calculated with a random-effects model according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I2 test.ResultsNine high-quality studies (n = 1156) were finally included. Supervised aerobic exercise was statistically more effective than conventional care in improving CRF among breast cancer survivors (SMD = −0.51, 95%CI −0.81 to −0.21), with high statistical heterogeneity (P = 0.001; I2 = 75%). Similar effects were found for resistance training on CRF (SMD = −0.41, 95%CI −0.76 to −0.05; P = 0.02; I2 = 64%). Meta-regression analysis revealed that exercise volume parameters are closely related with the effect estimates on CRF. Egger’s test suggested moderate evidence of publication bias (P = 0.04).ConclusionsSupervised exercise reduces CRF and must be implemented in breast cancer rehabilitation settings. High-volume exercises are safe and effective in improving CRF and overall quality of life in women with breast cancer. Further research is encouraged.Trial Registration CRD42014007223
Highlights
Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors
We considered the following validated tools for the measurement of fatigue levels: the Functional Assessment of Cancer Therapy (FACT)-Fatigue Scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQC30), Piper Fatigue Scale (PFS), Schwartz Cancer Fatigue Scale (SCFS) and the Multidimensional Fatigue Inventory (MFI)
Supervised exercise training groups comprised a total of 556 breast cancer survivors, and 460 women were allocated to control groups
Summary
Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors. Breast cancer is the most common cancer in women worldwide [1,2]. Breast cancer is a leading cause of cancer death among women, accounting for 23% of total cancer cases and 14% of cancer deaths [3]. The World Health Organization (WHO) [4] estimated that breast cancer incidence in South America was 114,898 cases in 2008. Due to significant improvements in screening protocols, diagnosis, and treatment over the Cancer-related fatigue (CRF) is the most common and devastating symptom in breast cancer patients during and after therapeutic treatment [8]. Breast cancer patients continue to experience fatigue symptoms for months or years after successful treatment. It has been suggested that CRF might be considered a strong predictor of lower survival for cancer patients [10]
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