Exercise-based interventions for preventing and treating cancer therapy-related cardiovascular toxicity: a systematic review and meta-analysis

Abstract

Abstract Background Cardiovascular toxicity is one of the most common side effects of cancer therapies. Physical exercise is regarded as a promising non-pharmacological therapy to prevent and mitigate cancer therapy-related cardiovascular toxicity (CTR-CVT) for cancer patients. Nevertheless, research evidence on its effects and optimal design remains unclear. Purpose This review aims to synthesize available data to evaluate the effects of exercise-based interventions on CTR-CVT in cancer patients and identify the potentially effective characteristics of exercise prescriptions. Methods Four databases (MEDLINE, Embase, Web of Science, and CENTRAL) were searched from the inception to October 2022 to identify eligible studies. Randomized controlled trials (RCTs) examining the effects of exercise-based interventions on CTR-CVT in cancer patients published in English were included. Risk of bias of included studies were assessed using the revised Cochrane "Risk of bias" tool for randomized trials (RoB 2.0). The meta-analysis was performed using statistical software R. Results Twenty studies with 1705 cancer patients were included. Our findings revealed that the VO2peak was significantly improved in the exercise-based intervention groups compared to the controls (standardized mean difference: 0.24, 95% confidence interval: 0.09 to 0.40). Evidence on other study outcomes remains unclear. The optimal characteristics of exercise programs could not be determined. Conclusion This review suggests that exercise-based interventions have the potential effects to prevent and treat CTR-CVT among cancer patients. Future well-designed RCTs are required to evaluate the impact of exercises on comprehensive CTR-CVT indicators.