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@ARTICLE{Eschke:142949,
      author       = {R. K. Eschke and A. Lampit and A. Schenk and F. Javelle and
                      K. Steindorf$^*$ and P. Diel and W. Bloch and P. Zimmer$^*$},
      title        = {{I}mpact of {P}hysical {E}xercise on {G}rowth and
                      {P}rogression of {C}ancer in {R}odents-{A} {S}ystematic
                      {R}eview and {M}eta-{A}nalysis.},
      journal      = {Frontiers in oncology},
      volume       = {9},
      issn         = {2234-943X},
      address      = {Lausanne},
      publisher    = {Frontiers Media},
      reportid     = {DKFZ-2019-00577},
      pages        = {35},
      year         = {2019},
      abstract     = {Background: Physical exercise is suspected to reduce cancer
                      risk and mortality. So far, little is known about the
                      underlying mechanisms. Although limited, murine models
                      represent a promising attempt in order to gain knowledge in
                      this field. Objective: A systematic review and meta-analysis
                      examining various treatment protocols was conducted in order
                      to determine the impact of exercise on tumor growth in
                      rodents. Methods: PubMed, Google scholar and System for
                      information on Gray literature in Europe were screened from
                      inception to October 2017. Risk of bias within individual
                      studies was assessed using the Office of Health Assessment
                      and Translation risk of bias rating tool for human and
                      animal trials. The effect of exercise on tumor growth over
                      and above non-exercise control was pooled using
                      random-effects model. Subgroup analyses were conducted to
                      identify potential moderators. Results: The quality of the
                      included 17 articles ranged between 'probably low' and 'high
                      risk of bias.' A significant reduction in tumor growth in
                      exercising animals compared to controls was detected
                      (Hedges' g = -0.40; $95\%$ CI -0.66 to -0.14, p < 0.01) with
                      between-study heterogeneity (τ2 = 0.217, I2 = $70.28\%,$ p
                      < 0.001). The heterogeneity was partially explained by three
                      moderators representing the in-between group differences of
                      'maximum daily exercise' R2 = $33\%$ (p < 0.01), 'type of
                      cancer administration' R2 = $28\%$ (p < 0.05), and 'training
                      initiation' R2 = $27\%$ (p < 0.05). Conclusion: This
                      meta-analysis suggests that physical exercise leads to
                      reduction of tumor size in rodents. Since 'maximum daily
                      exercise' was found to have at least modest impact on tumor
                      growth, more clinical trials investigating dose-response
                      relationships are needed.},
      subtyp        = {Review Article},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30805305},
      pmc          = {pmc:PMC6370688},
      doi          = {10.3389/fonc.2019.00035},
      url          = {https://inrepo02.dkfz.de/record/142949},
}