title: The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Adjuvant radiation therapy (RT) in breast cancer treatment has been proven to enhance outcome, improving recurrence and mortality rates. RT, however, gives rise to unfavourable side-effects, fatigue the most frequent. The aim of this study was to assess the effect of exercise (and different exercise prescription parameters) during adjuvant RT on fatigue among breast cancer patients. Quality of life was a secondary outcome.
  Randomised controlled trials that investigated the effect of exercise during adjuvant RT on fatigue for breast cancer patients were searched using MEDLINE, EMBASE, Google Scholar, CINAHL, AMED and ClinicalTrials.gov. Reference lists of included studies and relevant reviews were also checked.
  
  
  RESULTS
  Nine studies (802 participants) were included. A meta-analysis, including results for 738 participants, revealed that exercise was statistically more effective at reducing fatigue than the control intervention (SMD - 0.46, 95%CI -0.79 to -0.14). Statistically significant benefits of supervised, combined aerobicresistance exercise on fatigue were achieved. Further research is required to confirm this finding and determine the effect of alternative exercise modes.
  
  
  CONCLUSIONS
  Exercise during adjuvant RT can be considered beneficial in breast cancer patients. Supervised, combined aerobic-resistance exercise shows promise in alleviating fatigue with further investigation into alternative exercise modes required.
authors.affiliation: Applied Radiation Therapy Trinity (ARTT), School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lipsett
authors.affiliation: Applied Radiation Therapy Trinity (ARTT), School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Barrett
authors.affiliation: Applied Radiation Therapy Trinity (ARTT), School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Fatimah
authors.initials: F
authors.lastname: Haruna
authors.affiliation: University of Rochester Medical Center, School of Medicine and Dentistry, 601 Elmwood Ave, Box 647, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Mustian
authors.affiliation: Applied Radiation Therapy Trinity (ARTT), School of Medicine, Trinity College Dublin, Ireland. Electronic address: anita.odonovan@tcd.ie.
authors.forename: Anita
authors.initials: A
authors.lastname: O'Donovan
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic
keywords: Exercise; Fatigue; Quality of life; Radiotherapy; Survivorship