Anthracyclines are fundamental in the chemotherapy treatment of breast cancer, but these treatments often lead to changes in physique, such as increased body fat and decreased cardiopulmonary function, alongside gastrointestinal reactions and bone marrow suppression, thereby impacting the patients' quality of life. Current studies on the ameliorative effects of exercise on these side effects yield inconsistent results, necessitating further research. Clinically, the efficacy and safety of exercise prescriptions in mitigating these chemotherapy side effects in breast cancer patients warrant further exploration.

This study aims to investigate the effectiveness and safety of aerobic exercise in improving the physique and quality of life of breast cancer patients during anthracycline-based chemotherapy.

This study is a randomized controlled trial involving 44 adult female breast cancer patients who received anthracycline-based chemotherapy at Beijing Chaoyang Sanhuan Cancer Hospital, from March 2022 to January 2023. They were randomly assigned to an exercise group (23 participants) and a control group (21 participants). The control group was informed about personalized exercise guidance after chemotherapy. The exercise group, under the supervision of rehabilitation therapists, engaged in workouts during their hospital stay and continued personalized exercise interventions at home with self-monitoring and remote supervision by researchers. Key outcome measures, including physique and quality of life, were collected before and after chemotherapy, along with the incidence and severity of gastrointestinal reactions, bone marrow suppression, and exercise-related adverse events. Covariance analysis, using pre-chemotherapy data as covariates, compared the physique and quality of life between the two groups.

Four participants were lost during the intervention and follow-up, leaving 40 participants (21 in the exercise group, 19 in the control group). No severe adverse events were observed during the exercise intervention. The average compliance with the exercise intervention was 81.8%; average compliance per exercise session was 91.9%, and average compliance with exercise intensity was 92.5%. Post-chemotherapy, the exercise group showed lower body fat weight, body fat percentage, visceral fat area, waist circumference, waist-to-hip ratio, and significantly higher grip strength of the dominant hand and relative peak oxygen uptake (VO₂peak) compared to the control group (P<0.05). The incidence of functional impairments post-chemotherapy in the exercise group (7/20) was significantly lower than in the control group (12/16) (χ²=5.707, P=0.017). Post-chemotherapy, the exercise group reported significantly lower scores in physical condition, emotional condition, and additional scores, and higher functional condition scores than the control group (P<0.05). Post-chemotherapy, the control group's physical condition scores (P<0.001) and the exercise group's functional condition scores (P=0.017) were higher than pre-chemotherapy. The control and exercise groups underwent 84 and 94 anthracycline chemotherapy sessions, respectively, with the control group experiencing 84 gastrointestinal reactions and 71 bone marrow suppressions, and the exercise group experiencing 54 gastrointestinal reactions and 45 bone marrow suppressions, showing statistically significant differences between the groups (P<0.05) .

Aerobic exercise during anthracycline chemotherapy can improve the physique and quality of life of breast cancer patients and is safe when supervised.

蒽环类药物是乳腺癌基础化疗药物之一，但化疗常伴随着体质改变如体脂增加和心肺功能下降，胃肠道反应和骨髓抑制等毒副作用，影响患者的生活质量。目前关于运动改善以上毒副作用的研究结果不一致，有待进一步研究。临床上，应用运动处方改善乳腺癌患者以上化疗毒副作用的效果和安全性需要进一步探究。

探究有氧运动改善蒽环类药物化疗期间乳腺癌患者体质和生活质量的效果及有氧运动的安全性。

本研究是一项随机对照试验，纳入2022年3月—2023年1月在北京市朝阳区三环肿瘤医院接受蒽环类药物化疗方案的44例成年女性乳腺癌患者为研究对象，随机分为运动组（23例）与对照组（21例），对照组患者在化疗结束后提供个性化运动指导。运动组患者在化疗住院期间在康复师监督下进行锻炼，在家时通过患者自我监督和试验人员远程监督进行个性化运动干预。在化疗前后收集主要结局指标，包括体质和生活质量，记录胃肠道反应、骨髓抑制的发生次数、严重程度及运动相关不良事件。以化疗前数据为协变量，采用协方差分析比较两组体质情况和生活质量情况。

本研究干预、随访过程中共流失4例，最终纳入40例患者（运动组21例，对照组19例）。运动干预期间未观察到严重不良事件。运动干预期间，患者平均依从性为81.8%；每次运动时长的平均依从性为91.9%；运动强度平均依从性为92.5%。化疗后，运动组体脂重、体脂百分比、内脏脂肪面积、腰围、腰臀比低于对照组，惯用手握力、相对峰值摄氧量（VO₂peak）高于对照组（P<0.05）。化疗后运动组患者功能性障碍发生率（7/20）低于对照组（12/16）（χ²=5.707，P=0.017）。化疗后运动组生理状况、情感状况、附加得分低于对照组，功能状况得分高于对照组（P<0.05）。化疗后对照组生理状况分数（P<0.001）、运动组功能状况分数（P=0.017）高于化疗前。对照组和运动组患者分别共接受了84例次和94例次蒽环类药物化疗，对照组分别发生了84例次胃肠道反应和71次骨髓抑制，运动组分别发生了54例次胃肠道反应和45例次骨髓抑制，两组患者胃肠道反应和骨髓抑制发生情况比较，差异有统计学意义（P<0.05）。

在蒽环类药物化疗期间进行有氧运动可以改善乳腺癌患者的体质和生活质量，且有监督的有氧运动是安全的。