PMID 39548802

Research
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The Effect of High-Intensity Interval Training on Quality of Life and Incidence of Chemotherapy Side Effects in Women With Breast Cancer

Klavina A, Ceseiko R, Campa M, Jermolenko GF, Eglitis K, Llorente A, Linē A

Question

Does a 6-month individualized high-intensity aerobic interval walking program improve quality of life and reduce the incidence of neoadjuvant chemotherapy side effects in women with locally advanced breast cancer?

Summary

Women with stage II-III breast cancer undergoing neoadjuvant chemotherapy were randomized to a 6-month free-living walking HIIT program or standard care. Among the 37 participants included in per-protocol analyses, the HIIT group had better symptom-related quality-of-life outcomes and lower incidence of some chemotherapy-related physical, social, and fatigue side effects, while psychological complaints were more frequent in the HIIT group. No adverse events were reported during assessments or intervention sessions, but dropout was high and analysis excluded many randomized participants.

Methodology

  • Women with newly diagnosed locally advanced stage II-III breast cancer undergoing neoadjuvant chemotherapy.
  • 56 participants.
  • Walking HIIT on treadmill or participant-selected walking routes.
  • Work intervals: 4 x 4 minutes at 85%-95% HRmax, RPE 7-8 on Modified Borg scale.
  • Recovery: 3 minutes active recovery at 55%-70% HRmax between work intervals.
  • Intensity: Prescribed by individualized HRmax zones and Modified Borg RPE.
  • 34 minutes.
  • 2 to 3 sessions per week.
  • 6 months during neoadjuvant chemotherapy.
  • Randomized controlled trial with a 6-month free-living HIIT intervention and standard-care control; this publication used per-protocol analysis for quality-of-life and side-effect outcomes.
  • Quality of life, Chemotherapy side effects, and HIIT adherence were tracked.

Outcomes

Quality-of-life symptom scores

HIIT had significantly better post-intervention symptom outcomes than control for EORTC QLQ-C30 symptom scale, systemic therapy side effects, and QLQ-BR23 symptom scale.

EORTC QLQ-C30 symptom scale P=.048, ES=0.113; systemic therapy side effects P=.020, ES=0.154; QLQ-BR23 symptom scale P=.038, ES=0.124.

Improved

Weekly side-effect incidence

Physical, fatigue, and social functioning side-effect frequencies were lower in HIIT, while psychological complaints were higher.

Physical P=.016; fatigue P=.015; social P=.043 favoring HIIT. Psychological complaints were more frequent in HIIT, P=.023.

Mixed

Pain and sleep disturbances

Pain and sleep-disturbance self-reports were common and not statistically different between groups.

Pain frequency P=.877; sleep frequency P=.745.

No clear change

Adherence and adverse events

Analyzed HIIT participants averaged 79% adherence and no adverse events were reported during assessments or intervention sessions, but dropout from randomization to analysis was high.

HIIT adherence 79 +/- 14%, 51/64 sessions; 37 of 56 randomized participants included in final analyses.

Mixed

Insights

  • Walking-based 4 x 4-minute HIIT can be adapted to free-living settings with heart-rate monitoring and remote reporting.
  • For oncology populations, symptom monitoring and medical selection are integral to protocol translation.
  • Per-protocol benefits should be interpreted cautiously because dropout was high.
  • Remote app-based adherence workflows may help clinical exercise participants complete sessions, but technical proficiency matters.

Limitations

  • Small analyzed sample.
  • High dropout rate in both study groups.
  • Per-protocol analysis only for this publication.
  • Control was not attention-matched or exercise-dose matched.
  • Potential co-interventions such as counseling, immunotherapy, or medications were not fully captured.
  • Technical issues and varied Polar Flow proficiency limited accurate evaluation of intensity.

Safety

  • No adverse events were reported during assessments or intervention sessions.
  • All participants reported at least one chemotherapy-related side effect during the study period.
  • Severe neoadjuvant chemotherapy side effects were among the most frequent reasons for withdrawal.
  • Participants with contraindications to submaximal aerobic loads were excluded.