Abstract
OBJECTIVE: To compare the effects of exercise-based interventions on cardiometabolic health and fatigue in men with prostate cancer receiving androgen deprivation therapy (ADT). METHODS: A comprehensive search for Randomized controlled studies (RCTs) was performed in Pubmed, Embase, EBSCO, Web of science, Scopus, Cochrane library, Wanfang database, China National Knowledge Infrastructure (CNKI), VIP from their inception to May 2025. Meta-analysis and network meta-analysis was then conducted for each outcome using RevMan 5.4 and R 4.5.1. RESULTS: A total of 22 RCTs were included, involving 1579 patients with prostate cancer receiving ADT. The results of the meta-analysis indicated that exercise can significantly enhance cardiometabolic health and alleviate fatigue in men with prostate cancer receiving ADT. And the network meta-analysis showed that RET (Resistance Exercise Training) (SUCRA: 75.21%, 83.60%) was the most effective exercise for improving the whole-body fat mass and whole-body fat percentage; Home-based AET (Aerobic Exercise Training) + RET (SUCRA: 94.46%) were the most effective exercise in alleviating fatigue. Moreover, improvements in whole-body fat mass and whole-body fat percentage were proportional to the duration of the intervention. However, the optimal duration and frequency for improving fatigue still require further exploration. CONCLUSIONS: Network meta-analysis results show that the optimal exercises for improving cardiometabolic health and alleviating fatigue are RET and Home-based AET + RET. However, the certainty of this evidence is very low; further studies are required to identify the optimal type, duration, and frequency of exercise for improving cardiometabolic outcomes and fatigue in men with prostate cancer receiving ADT. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD420251047818).