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Meta-Analysis
. 2023 Mar-Apr;46(2):E81-E90.
doi: 10.1097/NCC.0000000000000957.

The Effectiveness of Sarcopenia Interventions for Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-analysis

Min Kyeong Jang  1 , Chang Park, Lisa Tussing-Humphreys, Bo Fernhall, Shane Phillips, Ardith Z Doorenbos
Affiliations
Meta-Analysis

The Effectiveness of Sarcopenia Interventions for Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-analysis

Min Kyeong Jang et al. Cancer Nurs. 2023 Mar-Apr.

Abstract

Background: Among people with cancer undergoing chemotherapy, generalized loss of muscle mass, termed secondary sarcopenia , is associated with treatment toxicities and physical disability.

Objective: This systematic review and meta-analysis aimed to provide an overview of current interventions for sarcopenia in cancer patients receiving chemotherapy and to assess potentially effective interventions.

Methods: We searched PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus, and EMBASE for primary original research of exercise and nutrition interventions for sarcopenia published in English. The review used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Standardized mean difference and 95% confidence interval (CI) were calculated as effect measures by applying the random-effects model.

Results: The 6 included studies showed a trend toward significantly increasing skeletal muscle mass after intervention (mean difference, 0.168; 95% CI, -0.015 to 0.352; P = .072), with no significant changes in lean body mass loss after intervention (mean difference, -0.014; 95% CI, -1.291 to 1.264; P = .983). Resistance exercise and combined exercise and nutrition intervention were more effective at preserving or increasing muscle mass.

Conclusions: Early implementation of a resistance exercise intervention or a combined exercise and nutrition intervention is a promising strategy for avoiding muscle mass loss during chemotherapy. Additional evidence-based assessments of interventions for secondary sarcopenia are needed to identify the most effective approach.

Implications for practice: In clinical practice, oncology nurses should frequently assess cancer patients' muscle mass and when warranted should implement the most feasible early sarcopenia intervention to minimize the adverse outcomes of this condition.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure. 1
Figure. 1. PRISMA flow diagram used in the identification and selection of studies
Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Figure 2.
Results of random-effects meta-analysis of effects of sarcopenia interventions on muscle mass change during cancer treatment.
Figure 3.
Figure 3.
Funnel plot for effects of sarcopenia interventions on muscle mass change during cancer treatment.
See this image and copyright information in PMC

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