Effectiveness of home-based exercise interventions on cardiorespiratory fitness and cancer treatment-related cardiovascular toxicity in cancer survivors exposed to cardiotoxic therapies: a systematic review and meta-analysis of randomized controlled trials.
Wei Wang, Geraldine A Lee, Wen Zhang et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis of randomized controlled trials assessed structured home-based exercise in cancer survivors exposed to cardiotoxic therapies. Ten trials involving 851 participants were included. Home-based exercise improved cardiorespiratory fitness: peak oxygen uptake increased by a mean difference of 2.35 mL/kg/min (95% CI: 1.26 to 3.43, p < 0.001). Subgroup analyses suggested larger effects with interventions lasting 24 to 52 weeks, mHealth use, and cancer Stage III/IV. Evidence was insufficient to establish prevention of treatment-related cardiovascular toxicity, and no significant improvement was found in six-minute walk distance or health-related quality of life.
Key findings
- Across 10 RCTs involving 851 participants, home-based exercise improved VO₂ peak (MD = 2.35 mL/kg/min, 95% CI: 1.26 to 3.43, p < 0.001).
- Subgroup analyses found larger fitness effects with 24 to 52-week programmes, mHealth use, and cancer Stage III/IV.
- Only one study assessed direct cardiotoxicity parameters or biomarkers, leaving evidence on cardiovascular toxicity limited.
- No significant improvements were found in the six-minute walk test or health-related quality of life.
Why it matters
Cardiorespiratory fitness is a relevant outcome for survivors who have received cardiotoxic cancer therapies. These findings suggest structured home-based programmes can improve peak oxygen uptake, but they do not establish that exercise prevents cardiac injury or clinical cardiovascular events. Distinguishing fitness benefits from cardioprotection is important when interpreting exercise evidence in survivorship care.
What to keep in mind
Direct cardiotoxicity parameters and biomarkers were assessed in only one study, limiting conclusions about prevention of cardiovascular toxicity.