Evaluation of Physical Activity and Lifestyle Interventions During and After Chemotherapy for Ovarian Cancer: A Systematic Review of Patient Experiences and Clinical Outcomes

Abstract

Ovarian cancer is a highly lethal gynecological malignancy, with chemotherapy-associated toxicity leading to fatigue, reduced physical function, and poor quality of life. Physical activity and lifestyle interventions may offer supportive benefits, but evidence in ovarian cancer remains limited and heterogeneous. This study aimed to assess how lifestyle modifications and physical activity during and after chemotherapy affect clinical outcomes and patient-reported experiences in women with ovarian cancer. A systematic review was conducted in accordance with PRISMA standards. PubMed, Embase, Scopus, and the Cochrane Library were searched from inception to May 2026. Methodological quality was evaluated using the Cochrane Risk of Bias tool (RoB 2.0) for randomized controlled trials and the Newcastle-Ottawa Scale (NOS) for cohort and prospective studies. Six studies, totaling 724 patients, were included. The interventions included aerobic, resistance, and multimodal exercise routines. Across studies, physical function (six-minute walk test (6MWT): 395-571 m), muscle strength, and mobility were maintained or enhanced. Fatigue levels improved consistently across validated scales in five studies. All studies found that quality of life increased or remained stable. In one study, exercise was linked to improved treatment tolerance, including appropriate chemotherapy dose intensity and lower neurotoxicity. Adherence (81%-92%) and retention (70%-100%) rates demonstrated high feasibility. Physical activity interventions during and after chemotherapy appear to be practical and effective in improving functional outcomes, fatigue, and quality of life in patients with ovarian cancer. More large-scale trials are required to standardize interventions and validate long-term benefits.