Optimal Exercise Modality and Dose to Alleviate Depressive and Anxiety Symptoms in Patients With Cancer: A Network Meta‐Analysis and Dose‐Response Study

OBJECTIVE: To compare the effects of different exercise modalities on depressive and anxiety symptoms in patients with cancer and to explore the exercise dose-response relationship to identify the optimal dose. METHODS: Randomized controlled trials published from database inception to January 2026 were searched in PubMed, Web of Science, Embase, and the Cochrane Library. Risk of bias was assessed using the Cochrane Risk of Bias tool. Stata 17.0 and R 4.4.3 were used for data transformation and statistical analyses, including comparisons of exercise modalities and dose-response evaluation for depressive and anxiety outcomes. RESULTS: Sixty-seven randomized controlled trials involving 5778 patients with cancer were included. Network meta-analysis showed that mind-body exercise (MBE), combined aerobic and resistance exercise (COM), and aerobic exercise (AE) significantly improved depressive symptoms, whereas resistance training (RT) did not. For anxiety, significant improvements were observed with MBE and AE, with MBE showing the greatest benefit for both outcomes. Dose-response analysis showed a nonlinear U-shaped association between total exercise dose and both depression and anxiety, with optimal doses of 770 and 700 MET-min/week, respectively. CONCLUSIONS: Different exercise modalities vary in their effects on depressive and anxiety symptoms in patients with cancer, with MBE showing the greatest overall benefit. The U-shaped dose-response relationship suggests that an appropriate exercise dose may help optimize improvements in depressive and anxiety symptoms and provide a basis for more precise exercise prescriptions based on exercise modality and dose.