title: Exercise for cancer cachexia in adults: Executive summary of a Cochrane Collaboration systematic review.
abstract: BACKGROUND
  Cancer cachexia is a complex syndrome characterized by an ongoing loss of skeletal muscle mass and progressive functional impairment. A proactive management approach is recommended, including physical exercise to maintain function via modulation of muscle metabolism, insulin sensitivity and levels of inflammation. The review aimed to determine the safety, acceptability and effectiveness of exercise in adults with cancer cachexia. Secondary aims, subject to the data availability, were to compare effectiveness according to the characteristics of the study intervention or population.
  
  
  METHODS
  We sought randomised controlled trials (RCTs) in adults meeting international criteria for cancer cachexia, comparing a programme of exercise as a sole or adjunct intervention to usual care or an active control. CENTRAL, MEDLINE, EMBASE, DARE and HTA, ISI Web of Science, LILACS, PEDro, SciVerse SCOPUS, Biosis Previews PreMEDLINE and Open Grey databases were searched up to June 2014. Two authors independently assessed studies for eligibility.
  
  
  RESULTS
  We screened 3154 separate titles and abstracts, and reviewed 16 full-texts. Corresponding authors were contacted to determine if samples met cachexia staging criteria. Most authors did not explore this concept. No trial met review eligibility criteria. We were unable to perform a meta-analysis to determine any effects from exercise intervention.
  
  
  CONCLUSIONS
  Despite a strong rationale for the use of exercise, there is insufficient evidence to determine safety and effectiveness in patients with cancer cachexia. Findings from ongoing studies are awaited. Assessment of cachexia domains, ideally against international criteria, is required for future trials of exercise and supportive care interventions.
authors.affiliation: University of Oxford, Nuffield Department of Population Health Oxford, UK ; Universidade do Extremo Sul Catarinense, Laboratory of evidence-based practice Criciuma, Santa Catarina, Brazil.
authors.forename: Antonio Jose
authors.initials: AJ
authors.lastname: Grande
authors.affiliation: Universidade Federal de Sao Paulo, Department of Internal Medicine Sao Paulo, Brazil.
authors.forename: Valter
authors.initials: V
authors.lastname: Silva
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation London, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Maddocks
keywords: Cachexia; Cancer; Exercise; Human; Physical activity