Objective: To study the effect of Tai Chi (TC) and resistance training (RT) with different intensity on the cancer-related fatigue (CRF) and quality of life (QoL) of middle-aged and elderly cancer patients.Methods: Totally 120 cancer patients were enrolled and randomly assigned to 4 groups by a random number table,including TC group,high-intensity 60％ one repetition maximum (1-RM) RT group (HIRT),low-intensity (30％ 1-RM) RT group (LIRT) and control group,30 patients in each group.Participants in the TC group received 24-form simplified Yang-style TC training at a frequency of 40 min per day,3 days per week for 12 weeks.Patients in the two RT groups received 10 sessions,6 designated movements per day,3 days per week for 12 weeks.The 1-RM of 6 muscle groups,fat mass (FM),lean body mass (LBM),along with the scores of Brief Fatigue Inventory (BFI),QoL questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC),Generalized Anxiety Disorder-7 (GAD-7),Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI) were measured before and after training.The adverse effect was also observed.Results: After 12-week intervention,patients in both TC and RT groups showed significant improvements in CRF and QLQ-CCC compared to pre-treatment (P＜0.05).Compared with the LIRT and TC groups,patients in the HIRT group improved more significantly in increasing muscle strength and LBM,and reducing in FM (P＜0.05).Patients in the TC group significantly increased in lower limb muscle strength compared with the LIRT group (P＜0.05).In addition,patients in the TC group showed more significant improvements in scores of GAD-7,PHQ-9 and PSQI than 2 RT groups (P＜0.05).Conclusions: TC and RT,both low-and high-intensity training,can significantly increase muscle strength,reduce CRF and improve QoL in the middle-aged and elderly cancer patients.TC has a better effect than RT in terms of sleep quality and mental health.The long-term application is needed to substantiate the effect of TC as an alternative exercise in cancer patients.