Abstract
BACKGROUND: Ovarian cancer, the most lethal gynecological malignancy, significantly impairs patients' quality of life (QOL), sleep quality, and body composition. Exercise has shown promise in mitigating these effects in other cancers, but evidence specific to ovarian cancer remains limited and heterogeneous. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases (PubMed, Embase, Web of Science, Cochrane Library) were searched up to April 2025 for randomized controlled trials evaluating exercise interventions in ovarian cancer patients. Outcomes included QOL, sleep quality (assessed via Pittsburgh Sleep Quality Index), BMI, and fatigue. Risk of bias was assessed using Cochrane RoB 2.0. Random-effects models were employed for meta-analysis, with heterogeneity evaluated via I2 statistics. RESULTS: Nine randomized controlled trials (n = 767) were included. Exercise significantly improved QOL (Standardised mean differences [SMD] 0.59, 95% CI 0.41-0.77; P < .001) and sleep quality (Pittsburgh Sleep Quality Index: SMD -0.56, 95% CI -0.84 to -0.25; P < .01), though heterogeneity was high for QOL (I2=98%). No significant effects were observed for BMI (SMD -0.20, 95% CI -0.92 to 0.51; P > .05) or fatigue (SMD -0.35, 95% CI -0.92 to 0.23; P > .05). Methodological limitations included bias in randomization and blinding. CONCLUSION: Exercise interventions may enhance QOL and sleep quality in ovarian cancer patients, but impacts on BMI and fatigue remain inconclusive. Future studies should prioritize rigorous designs and individualized approaches.