Background: Exercise interventions have been shown to improve sleep and reduce cancer-related fatigue (CRF) in individuals with cancer. However, the effects of aerobic (AT) and resistance training (RT) during neoadjuvant chemotherapy (NACT) remain unclear and have not been compared with training after surgery.
Aim: This study aimed to evaluate the impact of AT and RT during NACT on sleep and CRF and to compare these interventions with a wait-list control group (WCG) that performed RT after surgery regarding medium- and long-term effects.
Methods: In the BENEFIT study, 184 breast cancer patients (mean age: 49.9 years) were randomized to AT (n=62), RT (n=62), or WCG (n=60). AT and RT protocols consisted of two supervised sessions and one home-based session per week, conducted over a minimum duration of 18 weeks. Sleep (Pittsburgh Sleep Quality Index) and CRF (EORTC QLQ-FA12) were assessed at five time points: before NACT (T0), after 9 weeks (T1), after NACT (T2), 6 months post-surgery (T3), and 12 months post-surgery (T4). Actigraphy-based sleep data were collected at T0, T2, and T3.
Conclusion: Exercise interventions during NACT (AT and RT) did not significantly improve sleep or CRF compared to the WCG at T2. However, significant benefits were observed in the WCG, which trained post-surgery, showing improvements in self-reported sleep quality, total CRF, and physical CRF at T3 (all p < .05). Patients with elevated baseline fatigue and emotional distress derived the greatest benefits from post-surgical training. No significant effects were found on objective sleep parameters. While exercise during NACT may require additional measures to achieve benefits for sleep and CRF, this study highlights the effectiveness of post-surgical exercise in improving these outcomes in individuals with breast cancer.