Background: Breast cancer survivorship is frequently characterised by persistent impairments in cardiorespiratory fitness, muscle strength and health-related quality of life (QoL). The HOPE project evaluated a multicentre Exercise Therapy (ET) programme, with exploratory adjunctive use of high-ozonide ozonised oil, in women who had completed primary treatment for breast cancer. Methods: HOPE was a retrospective, multicentre observational study conducted across Italian Breast Units. Fifty-six women were screened; one declined participation. Thirty-five were allocated by routine clinical practice to ET plus high-ozonide ozonised oil (HOO), and twenty to ET alone. During the 8-week programme, five participants per group discontinued, leaving 45 completers (IG n = 30; CG n = 15) for analysis. ET was delivered twice weekly in a hybrid format (one supervised in-person session and one remote session). Outcomes were assessed at baseline (T0) and after 2 months (T1) and included estimated VO₂max (2-km walk test), QoL (SF-36; PCS/MCS and domains), estimated 1RM strength, anthropometry/body composition (BIA), circumferences, and lower-limb function (SPPB). Within-group changes were tested with Wilcoxon signed-rank tests; between-group comparisons of change scores (Δ=T1–T0) used Mann–Whitney U tests (two-sided α=0.05). Results: In the total cohort, VO₂max increased significantly (mean Δ +4.42 ml/kg/min; p = 0.001; n = 38). Improvements were significant in IG (mean Δ +5.82; p = 0.002) but not in CG (mean Δ +1.73; p = 0.196), with no significant between-group difference in ΔVO₂max (p = 0.115). QoL improved, with significant increases in PCS (mean Δ +3.65; p = 0.0001) and MCS (mean Δ +3.78; p = 0.0005); between-group differences in ΔPCS and ΔMCS were not significant (p = 0.87 and p = 0.914, respectively). Maximal strength increased across all assessed muscle groups (deltoid, latissimus dorsi, pectoralis, quadriceps; all p≤0.0002). Weight, BMI and fat mass decreased (p≤0.0029), whereas fat-free mass did not change significantly. Peripheral circumferences showed selective reductions (e.g. chest and thigh), while waist and hip circumferences were unchanged. SPPB change did not reach significance (mean Δ +0.11; p = 0.059), consistent with near-ceiling baseline performance. Conclusions: A short, supervised hybrid ET programme implemented in routine Breast Unit care was associated with clinically meaningful improvements in cardiorespiratory fitness, QoL and strength, alongside favourable changes in body composition. No statistically significant between-group differences were detected for primary or secondary outcomes over 8 weeks, suggesting that the exercise component was the dominant driver of benefit, while any additive effect of high-ozonide ozonised oil remains unproven and warrants prospective controlled evaluation.
Promozione delle performance fisiche e della qualità della vita in donne operate per tumore alla mammella mediante attività fisica adattata e olio ozonizzato - Health through Ozonized oil and Physical Exercise for breast cancer - HOPE Project
RUZZARIN, NICOLÒ
2026-05-12
Abstract
Background: Breast cancer survivorship is frequently characterised by persistent impairments in cardiorespiratory fitness, muscle strength and health-related quality of life (QoL). The HOPE project evaluated a multicentre Exercise Therapy (ET) programme, with exploratory adjunctive use of high-ozonide ozonised oil, in women who had completed primary treatment for breast cancer. Methods: HOPE was a retrospective, multicentre observational study conducted across Italian Breast Units. Fifty-six women were screened; one declined participation. Thirty-five were allocated by routine clinical practice to ET plus high-ozonide ozonised oil (HOO), and twenty to ET alone. During the 8-week programme, five participants per group discontinued, leaving 45 completers (IG n = 30; CG n = 15) for analysis. ET was delivered twice weekly in a hybrid format (one supervised in-person session and one remote session). Outcomes were assessed at baseline (T0) and after 2 months (T1) and included estimated VO₂max (2-km walk test), QoL (SF-36; PCS/MCS and domains), estimated 1RM strength, anthropometry/body composition (BIA), circumferences, and lower-limb function (SPPB). Within-group changes were tested with Wilcoxon signed-rank tests; between-group comparisons of change scores (Δ=T1–T0) used Mann–Whitney U tests (two-sided α=0.05). Results: In the total cohort, VO₂max increased significantly (mean Δ +4.42 ml/kg/min; p = 0.001; n = 38). Improvements were significant in IG (mean Δ +5.82; p = 0.002) but not in CG (mean Δ +1.73; p = 0.196), with no significant between-group difference in ΔVO₂max (p = 0.115). QoL improved, with significant increases in PCS (mean Δ +3.65; p = 0.0001) and MCS (mean Δ +3.78; p = 0.0005); between-group differences in ΔPCS and ΔMCS were not significant (p = 0.87 and p = 0.914, respectively). Maximal strength increased across all assessed muscle groups (deltoid, latissimus dorsi, pectoralis, quadriceps; all p≤0.0002). Weight, BMI and fat mass decreased (p≤0.0029), whereas fat-free mass did not change significantly. Peripheral circumferences showed selective reductions (e.g. chest and thigh), while waist and hip circumferences were unchanged. SPPB change did not reach significance (mean Δ +0.11; p = 0.059), consistent with near-ceiling baseline performance. Conclusions: A short, supervised hybrid ET programme implemented in routine Breast Unit care was associated with clinically meaningful improvements in cardiorespiratory fitness, QoL and strength, alongside favourable changes in body composition. No statistically significant between-group differences were detected for primary or secondary outcomes over 8 weeks, suggesting that the exercise component was the dominant driver of benefit, while any additive effect of high-ozonide ozonised oil remains unproven and warrants prospective controlled evaluation.
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