Various interventions for cancer-related fatigue in patients with breast cancer: a systematic review and network meta-analysis

Ying Li; Lei Gao; Yaqing Chao; Tianhao Lan; Jie Zhang; Ruoqi Li; Zerui Zhang; Shuming Li; Jing Lian; Zhaofeng Wang; Xiaoan Chen

doi:10.3389/fonc.2024.1341927

Various interventions for cancer-related fatigue in patients with breast cancer: a systematic review and network meta-analysis

Front Oncol. 2024 Feb 9:14:1341927. doi: 10.3389/fonc.2024.1341927. eCollection 2024.

Authors

Ying Li¹, Lei Gao², Yaqing Chao³, Tianhao Lan⁴, Jie Zhang¹, Ruoqi Li⁵, Zerui Zhang⁶, Shuming Li¹, Jing Lian⁷, Zhaofeng Wang⁸, Xiaoan Chen¹

Affiliations

¹ College of Sports Science, Jishou University, Jishou, Hunan, China.
² School of Nursing, Dalian University, Dalian, Liaoning, China.
³ Ophthalmology Department, Xuzhou First People's Hospital, Xuzhou, Jiangsu, China.
⁴ School of Stomatology, Dalian University, Dalian, Liaoning, China.
⁵ The Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
⁶ Medical School, Weifang University of Science and Technology, Weifang, Shandong, China.
⁷ Department of Pathology, Cancer Hospital Affiliated to Shanxi Province Cancer Hospital, Taiyuan, Shanxi, China.
⁸ College of Physical Education, Beibu Gulf University, Qinzhou, Guangxi, China.

Abstract

Purpose: To investigate the effects of various intervention approaches on cancer-related fatigue (CRF) in patients with breast cancer.

Method: Computer searches were conducted on PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to June 2023. Selection was made using inclusion and exclusion criteria, and 77 articles were included to compare the effects of 12 interventions on patients with breast cancer.

Results: Seventy-seven studies with 12 various interventions were examined. The network findings indicated that cognitive behavioral therapy (CBT) (SMD, -1.56; 95%CI, -3.08~-0.04), Chinese traditional exercises (CTE) (SMD, -0.85; 95%CI, -1.34~-0.36), aerobic exercise (AE) (SMD, -0.77; 95%CI, -1.09~-0.45), multimodal exercise (ME) (SMD, -0.75; 95%CI, -1.26~-0.25), music interventions (MI) (SMD, -0.74; 95%CI, -1.45~-0.03), and yoga (YG) (SMD, -0.44; 95%CI, -0.83 to -0.06) can reduce CRF more than the control group (CG). For relaxation exercises (RE) (MD, -6.69; 95%CI, -9.81~-3.57), MI (MD, -5.45; 95%CI, -7.98~-2.92), AE (MD, -4.34; 95%CI, -5.90~-2.78), ME (MD, -3.47; 95%CI, -4.95~-1.99), YG (MD, -2.07; 95%CI, -3.56~-0.57), and mindfulness training (MD, -1.68; 95%CI, -2.91~-0.46), PSQI improvement was superior to CG. In addition, for CTE (MD, 11.39; 95%CI, 4.11-18.66), YG (MD, 11.28; 95%CI, 1.63-20.93), and AE (MD, 9.34; 95%CI, 0.26~18.42), Functional Assessment of Cancer Therapy-Breast improvement was superior to CG.

Conclusion: Cognitive behavioral therapy (CBT) is the most effective measure for alleviating CRF in patients with breast cancer and Relaxation exercises (RE) is the most effective measure for improving sleep quality. In addition, Chinese traditional exercises (CTE) is the best measure for enhancing quality of life. Additional randomized controlled trials (RCTs) are expected to further investigate the efficacy and mechanisms of these interventions.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023471574.

Keywords: CFR; breast cancer; cancer; network meta-analysis; systematic review.

Publication types

Systematic Review

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.