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Effect of aerobic exercise on cardiotoxic outcomes in women with breast cancer undergoing anthracycline or trastuzumab treatment: a systematic review and meta-analysis

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Abstract

Purpose

We aimed to assess the impact of aerobic exercise (AE) on parameters related to cardiotoxicity in breast cancer (BC) patients receiving anthracycline or trastuzumab.

Methods

We performed a systematic review and meta-analysis of comparative studies on AE via the screening of standard databases from their inception to January 18, 2022. The risk of bias was assessed qualitatively using the domains outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed quantitatively using fixed effects meta-analysis and subgroup analysis in RevMan software. Notable outcomes included imaging outcomes of cardiotoxicity, cardiorespiratory fitness, and cardiac biomarkers.

Results

A meta-analysis of the pooled evidence obtained from seven studies revealed that AE significantly increased peak oxygen consumption (VO2 peak) and E/A values, compared to the values observed during usual care. Moreover, AE was safe and feasible, and was associated with a lower risk of adverse effects, a higher participation rate, and better results, when combined with resistance exercise.

Conclusion

In BC patients receiving anthracyclines or trastuzumab, the effects of AE on the levels of cardiotoxicity were mixed; the diastolic functions and VO2 peak values were improved, biomarkers were not affected, and the overall improvements in the levels of cardiotoxicity were promising, despite the use of different exercise parameters.

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Data availability

Full disclosure, as seen in the supplementary material in the appendix.

Code availability

Applicable.

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Funding

This work was supported by the Nursing Project of Superior Discipline Construction in Jiangsu Universities (szbf [2018] No. 87), and Nursing Science, a Key Discipline Project of Jiangsu Province during the 13th Five-Year Plan period (sjy [2016] No. 9).

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Authors and Affiliations

  1. School of Nursing, Nanjing Medical University, Nanjing, China

    Zhu-yue Ma, Yan-yan Shi, Ning-ning Lu & Fang Cheng

  2. Jiangsu Cancer Hospital & The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Reasearch, Nanjing, China

    Shan-shan Yao

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Contributions

ZM and SY contributed equally to this work. ZM and SY have made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; YS and NL have critically drafted the important intellectual content of the article; FC approved the version to be published and all subsequent versions.

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Correspondence to Fang Cheng.

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Zhu‑yue Ma and Shan‑shan Yao shared first authorship.

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Ma, Zy., Yao, Ss., Shi, Yy. et al. Effect of aerobic exercise on cardiotoxic outcomes in women with breast cancer undergoing anthracycline or trastuzumab treatment: a systematic review and meta-analysis. Support Care Cancer 30, 10323–10334 (2022). https://doi.org/10.1007/s00520-022-07368-w

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