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

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 I(2) 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.