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. 2023 May 30;12(5):633-650.
doi: 10.21037/gs-23-126. Epub 2023 May 26.

The effects of exercise on the quality of life of patients with breast cancer: a systematic review and meta-analysis based on the QLQ-C30 quality of life scale

Lijie Chen  1 , Puchao Peng  1 , Zhouming Xu  1 , Xiufang Ding  1
Affiliations

The effects of exercise on the quality of life of patients with breast cancer: a systematic review and meta-analysis based on the QLQ-C30 quality of life scale

Lijie Chen et al. Gland Surg. .

Abstract

Background: Studies have reported that exercise can effectively improve the quality of life of breast cancer (BC) patients. However, considering the differences in exercise form and intensity, it is difficult to quantify and unify the improved outcomes, and there are contradictions in the conclusions. This meta-analysis aimed to quantitatively evaluate the effects of exercise on the quality of life (QoL) of patients with BC based on the European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (QLQ-C30) scale, to provide optimization suggestions for the treatment plan of BC survivors.

Methods: The literature were extracted from the databases of PubMed, Embase, Cochrane Library, Wanfang, and China National Knowledge Infrastructure. The main outcomes were extracted from the final included literature and chi square tests and I2 statistics were used to evaluate the heterogeneity among the included studies. Statistical analysis was performed by Stata/SE 16.0 software and Review Manager 5.4 software. The funnel plot was used to test for evaluation publication bias.

Results: All 8 included articles were original studies. The risk bias evaluation showed that 2 articles had low risk of bias and 6 articles had uncertain risk of bias. The results of meta-analysis revealed the following: (I) exercise significantly improved the overall health status of BC patients [mean difference (Hedges's g) =0.81, 95% confidence interval (CI): 0.27, 1.34]; (II) exercise significantly improved the physiological function of patients (Hedges's g =0.78, 95% CI: 0.34, 1.22), daily life function (Hedges's g =0.45, 95% CI: 0.13, 0.77), emotional function (Hedges's g =0.52, 95% CI: 0.20, 0.84); (III) exercise significantly reduced the fatigue symptoms (Hedges's g =-0.51, 95% CI: -0.84, -0.19), nausea and vomiting symptoms (Hedges's g =-0.35, 95% CI: -0.60, -0.10), insomnia symptoms (Hedges's g =-0.59, 95% CI: -0.91, -0.26), and economic difficulties (Hedges's g =-0.48, 95% CI: -0.78, -0.18) of patients.

Conclusions: Exercise can significantly improve the overall physical health and body functions of BC survivors. Exercise can also significantly reduce the symptoms of fatigue, nausea, vomiting, and insomnia in BC patients. Different levels of exercise have significant effects on improving the quality of life of BC survivors, which is worth being widely advocated.

Keywords: Breast cancer; Quality of Life Questionnaire-C30 scale (QLQ-C30 scale); exercise; quality of life (QoL).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-23-126/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of literatures screening. CKNI, China National Knowledge Infrastructure; RCT, randomized controlled trial.
Figure 2
Figure 2
Quality assessment of included studies. Low risk of bias (represented by green “+”), high risk of bias (represented by red “-”), uncertain risk of bias (represented by yellow “?”).
Figure 3
Figure 3
Quality assessment of included studies.
Figure 4
Figure 4
Forest plot of the improvement of overall health status of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 5
Figure 5
Forest plot of physical function improvement in patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 6
Figure 6
Forest plot of the improvement in daily life function of patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 7
Figure 7
Forest plot of the improvement of emotional function in patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 8
Figure 8
Forest plot of the cognitive function improvement in patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 9
Figure 9
Forest plot of the improvement of social function of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval.
Figure 10
Figure 10
Forest plot of the improvement of fatigue symptoms of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 11
Figure 11
Forest plot of the improvement of nausea and vomiting symptoms of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 12
Figure 12
Forest plot of the improvement of pain symptoms in patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 13
Figure 13
Forest plot of the improvement of dyspnea symptoms of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 14
Figure 14
Forest plot of the improvement of insomnia symptoms in patients with breast cancer after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 15
Figure 15
Forest plot of the improvement of the symptoms of loss of appetite in breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 16
Figure 16
Forest plot of the improvement of constipation symptoms in breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 17
Figure 17
Forest plot of the improvement of diarrhea symptoms of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 18
Figure 18
Forest plot of the improvement of the economic status of breast cancer patients after exercise. SD, standard deviation; CI, confidence interval; REML, restricted maximum likelihood.
Figure 19
Figure 19
Funnel plot (global health status). CI, confidence interval.
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