title: Evaluation of resistance training to improve muscular strength and body composition in cancer patients undergoing neoadjuvant and adjuvant therapy: a meta-analysis.
abstract: OBJECTIVE
  Muscle atrophy and strength decline are two of the most prominent characteristics in cancer patients undergoing cancer therapy, leading to decreased functional ability and reduced quality of life. Therefore, the aim is to systematically review research evidence of the effects of resistance exercise (RE) on lower-limb muscular strength, lean body mass (LBM), and body fat (BF) in cancer patients undertaking neoadjuvant or adjuvant therapy.
  
  
  METHODS
  This research was conducted using the following online database: Clinical Trial Register, Cochrane Trial Register, PubMed, SPORT Discus, and SciELO, from September 2014 until May 2015. We used the following keywords in various combinations with a systematic search: "Cancer therapy," "Wasting muscle," "Muscle loss," "Muscle function," "Neoadjuvant therapy," "Adjuvant thera-py," "Resistance Training," "Weight training," and "Exercise." After selection of 272 full-text articles, 14 publications were included in this meta-analysis.
  
  
  RESULTS
  Resistance exercise (RE) during neoadjuvant or adjuvant therapy increased lower-limb muscular strength (mean: 26.22 kg, 95% CI [16.01, 36.43], heterogeneity: P = <0.01, I2= 76%, P = 0.00001) when compared to controls over time. Similarly, lean body mass (LBM) increased (mean 0.8 kg, 95% CI [0.7, 0.9], heterogeneity: P = 0.99, I2= 0%, P < 0.00001), and decreased body fat (BF) (mean: -1.3 kg, 95% CI [-1.5, 1.1], heterogeneity: P = 0.93, I2= 0%, P < 0.00001) compared to controls over time.
  
  
  CONCLUSIONS
  RE is effective to increase lower-limb muscular strength, increase LBM, and decrease BF in cancer patients undergoing neoadjuvant and adjuvant therapy regardless of the kind of treatment.
  
  
  CONCLUSIONS
  RE increases muscle strength, maintains LBM, and reduces BF in cancer patients undergoing adjuvant and neoadjuvant therapies. Cancer patients and survivors should consider undertaking RE as an effective countermeasure for treatment-related adverse effects to the musculoskeletal system.
authors.affiliation: Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina, PR, Brazil. camilapersonal@yahoo.com.br.
authors.forename: Camila S
authors.initials: CS
authors.lastname: Padilha
authors.affiliation: Molecular Pathology Laboratory, Department of Pathology Science, State University of Londrina, Londrina, PR, Brazil.
authors.forename: Poliana Camila
authors.initials: PC
authors.lastname: Marinello
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Galvão
authors.affiliation: Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
authors.forename: Robert U
authors.initials: RU
authors.lastname: Newton
authors.affiliation: Laboratory Pathophysiology and Free Radical, Department of Pathology Science, State University of Londrina, Londrina, PR, Brazil.
authors.forename: Fernando H
authors.initials: FH
authors.lastname: Borges
authors.affiliation: Program of Molecular Carcinogenesis, Brazilian National Institute of Cancer (INCA), Rio de Janeiro, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Frajacomo
authors.affiliation: Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina, PR, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Deminice
mesh_terms: D001823:Body Composition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D020360:Neoadjuvant Therapy / Q000379:methods*; D009369:Neoplasms / Q000628:therapy*; D055070:Resistance Training / Q000379:methods*
keywords: Body fat; Cancer treatment; Resistance exercise; Skeletal muscle