***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Exercise training is an effective and safe way to counteract cancer-related fatigue ( CRF ) and to improve health-related quality of life ( HRQoL ) .  High-intensity interval training has proven beneficial for the health of clinical population s. The aim of this r and omized controlled trial was to compare the effects of resistance and high-intensity interval training ( RT – HIIT ) , and moderate-intensity aerobic and high-intensity interval training ( AT – HIIT ) to usual care ( UC ) in women with breast cancer undergoing chemotherapy . The primary endpoint was CRF and the secondary endpoints were HRQoL and cancer treatment-related symptoms . Methods Two hundred and forty women planned to undergo chemotherapy were r and omized to supervised RT – HIIT , AT – HIIT , or UC . Measurements were performed at baseline and at 16 weeks . Question naires included Piper Fatigue Scale , EORTC-QLQ-C30 , and Memorial Symptom Assessment Scale . Results The RT – HIIT group was superior to UC for CRF : total CRF ( p = 0.02 ) , behavior/daily life ( p = 0.01 ) , and sensory/physical ( p = 0.03 ) CRF . Role functioning significantly improved while cognitive functioning was unchanged for RT – HIIT compared to declines shown in the UC group ( p = 0.04 ) . AT – HIIT significantly improved emotional functioning versus UC ( p = 0.01 ) and was superior to UC for pain symptoms ( p = 0.03 ) . RT – HIIT reported a reduced symptom burden , while AT – HIIT remained stable compared to deteriorations shown by UC ( p < 0.01 ) . Only RT – HIIT was superior to UC for total symptoms ( p < 0.01 ) . Conclusions 16 weeks of resistance and HIIT was effective in preventing increases in CRF and in reducing symptom burden for patients during chemotherapy for breast cancer . These findings add to a growing body of evidence supporting the inclusion of structured exercise prescriptions , including HIIT , as a vital component of cancer rehabilitation . Trial registration Clinical trials.gov Registration Number : NCT02522260 Background Promoting quality of life ( QoL ) is a key priority in cancer care . We investigated the hypothesis that , in comparison to usual care , exercise post-neoadjuvant chemoradiation therapy/prior to surgical resection will reduce pain , fatigue , and insomnia , and will improve physical and mental health perceptions in patients with locally advanced stage rectal cancer . Methods In this non-r and omized controlled pilot trial , patients in the supervised exercise group ( EG ; Mage = 64 years ; 64 % male ) and in the control group ( CG ; Mage = 72 years ; 69 % male ) completed the European Organization for Research and Treatment of Cancer core Quality of Life question naire and the R AND 36-Item Health Survey three times : pre-neoadjuvant chemoradiation therapy ( Time 1 ; nEC = 24 ; nCG = 11 ) , post-neoadjuvant chemoradiation therapy/pre-exercise intervention ( Time 2 ; nEC = 23 ; nCG = 10 ) , and post-exercise intervention ( Time 3 ; nEC = 22 ; nCG = 10 ) . The 6-week exercise intervention was delivered in hospital and comprised of interval aerobic training . Patients trained in pairs three times per week for 30 to 40 min . Data were analyzed by Mann – Whitney tests and by Wilcoxon matched-pairs signed-rank tests . Results No significant between-group differences in changes were found for any of the outcomes . In both groups , fatigue levels decreased and physical health perceptions increased from pre- to post-exercise intervention . Pain levels also decreased from pre- to post-exercise intervention , albeit not significantly . Conclusions The findings from this study can be used to guide a more definitive trial as they provide preliminary evidence regarding the potential effects of pre-operative exercise on self-reported pain , fatigue , insomnia , and health perceptions in patients with locally advanced rectal cancer . Trial registration : This study has been registered with clinical trials.gov ( NCT01325909 ; March 29 , 2011 ) BACKGROUND Patients requiring surgery for locally advanced rectal cancer often additionally undergo neoadjuvant chemoradiotherapy ( NACRT ) , of which the effects on physical fitness are unknown . The aim of this feasibility and pilot study was to investigate the effects of NACRT and a 6 week structured responsive exercise training programme ( SRETP ) on oxygen uptake [ Formula : see text ] at lactate threshold ( [ Formula : see text ] ) in such patients . METHODS We prospect ively studied 39 consecutive subjects ( 27 males ) with T3 - 4/N+ resection margin threatened rectal cancer who completed st and ardized NACRT .  Subjects underwent cardiopulmonary exercise testing at baseline ( pre-NACRT ) , at week 0 ( post-NACRT ) , and week 6 ( post-SRETP ) . Twenty-two subjects undertook a 6 week SRETP on a training bike ( three sessions per week ) between week 0 and week 6 ( exercise group ) . These were compared with 17 contemporaneous non-r and omized subjects ( control group ) . Changes in [ Formula : see text ] at [ Formula : see text ] over time and between the groups were compared using a compound symmetry covariance linear mixed model . RESULTS Of 39 recruited subjects , 22 out of 22 ( exercise ) and 13 out of 17 ( control ) completed the study . There were differences between the exercise and control groups at baseline [ age , ASA score physical status , World Health Organisation performance status , and Colorectal Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity ( CR-POSSUM ) predicted mortality ] . In all subjects , [ Formula : see text ] at [ Formula : see text ] significantly reduced between baseline and week 0 [ -1.9 ml kg(-1 ) min(-1 ) ; 95 % confidence interval ( CI ) -1.3 , -2.6 ; P<0.0001 ] . In the exercise group , [ Formula : see text ] at [ Formula : see text ] significantly improved between week 0 and week 6 ( + 2.1 ml kg(-1 ) min(-1 ) ; 95 % CI + 1.3 , + 2.9 ; P<0.0001 ) , whereas the control group values were unchanged ( -0.7 ml kg(-1 ) min(-1 ) ; 95 % CI -1.66 , + 0.37 ; P=0.204 ) . CONCLUSIONS NACRT before rectal cancer surgery reduces physical fitness . A structured exercise intervention is feasible post-NACRT and returns fitness to baseline levels within 6 weeks . CLINICAL TRIAL REGISTRATION NCT 01325909 OBJECTIVES Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer . This r and omized trial evaluates the impact of adding rehabilitation ( Rehab ) with high-intensity interval training ( HIIT ) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome . METHODS Patients with operable lung cancer were r and omly assigned to  usual care ( UC , n = 77 ) or to intervention group ( Rehab  , n = 74 ) that entailed HIIT that was implemented only preoperatively .  Cardiopulmonary exercise testing ( CPET ) and pulmonary functional tests ( PFTs ) including forced vital capacity ( FVC ) , forced expiratory volume ( FEV 1 ) and carbon monoxide transfer factor ( KCO ) were performed before and 1 year after surgery . RESULTS During the preoperative waiting time ( median 25 days ) , Rehab patients participated to a median of 8 HIIT sessions ( interquartile [ IQ ] 25 - 75 % , 7 - 10 ) . At 1 year follow-up , 91 % UC patients and 93 % Rehab patients were still alive ( P = 0.506 ) . Pulmonary functional changes were non-significant and comparable in both groups ( FEV 1 mean -7.5 % , 95 % CI , -3.6 to -12.9 and in KCO mean 5.8 % 95 % CI 0.8 - 11.8 ) Compared with preoperative CPET results , both groups demonstrated similar reduction in peak oxygen uptake ( mean -12.2 % 95 % CI -4.8 to -18.2 ) and in peak work rate ( mean -11.1 % 95 % CI -4.2 to -17.4 ) . CONCLUSIONS Short-term preoperative rehabilitation with HIIT does not improve pulmonary function and aerobic capacity measured at 1 year after lung cancer resection . TRIAL REGISTRY Clinical Trials.gov ; No. NCT01258478 ; www . clinical trials.gov Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVES The aim of this study was to determine whether ectopic fat depots are prospect ively associated with  cardiovascular disease , cancer , and all-cause mortality .  BACKGROUND The morbidity associated with excess body weight varies among individuals of similar body mass index . Ectopic fat depots may underlie this risk differential . However , prospect i ve studies of directly measured fat are limited . METHODS Participants from the Framingham Heart Study ( n = 3,086 ; 49 % women ; mean age of 50.2 years ) underwent assessment of fat depots ( visceral adipose tissue , pericardial adipose tissue , and periaortic adipose tissue ) using multidetector computed tomography and were followed up longitudinally for a median of 5.0 years . Cox proportional hazards regression models were used to examine the association of each fat depot ( per 1 SD increment ) with the risk of incident cardiovascular disease , cancer , and all-cause mortality after adjustment for st and ard risk factors , including body mass index . RESULTS Overall , there were 90 cardiovascular events , 141 cancer events , and 71 deaths . After multivariable adjustment , visceral adipose tissue was associated with cardiovascular disease ( hazard ratio : 1.44 ; 95 % confidence interval : 1.08 to 1.92 ; p = 0.01 ) and cancer ( hazard ratio : 1.43 ; 95 % confidence interval : 1.12 to 1.84 ; p = 0.005 ) . Addition of visceral adipose tissue to a multivariable model that included body mass index modestly improved cardiovascular risk prediction ( net reclassification improvement of 16.3 % ) . None of the fat depots were associated with all-cause mortality . CONCLUSIONS Visceral adiposity is associated with incident cardiovascular disease and cancer after adjustment for clinical risk factors and generalized adiposity . These findings support the growing appreciation of a pathogenic role of ectopic fat BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group , a group organized by Cancer Care Ontario 's Program in Evidence -Based Care ( pebc ) . The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer , focusing on the benefits of specific types of exercise , recommendations about screening requirements for new referrals , and safety concerns . METHODS Consistent with the pebc 's st and ardized approach , a systematic search was conducted for existing guidelines , and systematic literature search es were performed in medline and embase for both systematic review s and primary literature . Content and methodology experts performed an internal review , which was followed by an external review by targeted experts and intended users . RESULTS The search identified three guidelines , eighteen systematic review s , and twenty-nine r and omized controlled trials with relevance to the topic . The present guideline provides recommendations for the duration , frequency , and intensity of exercise appropriate for people living with cancer . It also provides recommendations for pre-exercise assessment , safety concerns , and delivery models . CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment , and that it does not cause harm . The present guideline is intended to support the Canadian Society for Exercise Physiology 's Canadian physical activity guidelines . The recommendations are intended for clinicians and institutions treating cancer patients in Ontario , and for policymakers and program planners involved in the delivery of exercise programs for cancer patients Purpose Peak oxygen consumption ( VO2peak ) is an important predictive factor for long-term prognosis in patients with non-small cell lung cancer ( NSCLC ) . The purpose of this study was to investigate whether 8 weeks of exercise training improves exercise capacity , as assessed by VO2peak , and other related factors in patients with NSCLC receiving targeted therapy . Methods A total of 24 participants with adenocarcinoma were r and omly assigned to either the control group ( n = 11 ) or the exercise group ( n = 13 ) . Subjects in the exercise group participated in individualized , high-intensity aerobic interval training of exercise . The outcome measures assessed at baseline and after 8 weeks were as follows : VO2peak and the percentage of predicted VO2peak ( % predVO2peak ) , muscle strength and endurance of the right quadriceps , muscle oxygenation during exercise , insulin resistance as calculated by the homeost 
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Similarly , no superior effects of HIIT compared to MIE were found for quality of life or changes in lean mass , while evidence was provided for a larger reduction in fat mass .
Conclusion This systematic review showed that short-term HIIT induces similar positive effects on physical fitness and health-related outcomes as MIE but seems to be superior compared to UC .
Thus , HIIT might be a time-efficient intervention for cancer patients across all stages of therapy and aftercare .
Implication s for Cancer SurvivorsHigh-intensity interval training ( HIIT ) is superior compared to usucal care in improving physical fitness and health-related outcomes in cancer patients across all stages of therapy and aftercare .
Currently , there is no evidence for the benefits of HIIT compared to aerobic training of moderate intensity ( MIE )  for changes in cardiorespiratory fitness , lean mass and patient-reported outcomes .
Reductions in fat mass may be more pronounced in HIIT compared to MIE when training is performed in aftercare