Tracy D Vannorsdall1,2,3, Ermiece Straub4, Christina Saba4, Mallory Blackwood4, Jingyi Zhang4, Keren Stearns4, Karen Lisa Smith5. 1. Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. TVannor1@jhmi.edu. 2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. TVannor1@jhmi.edu. 3. , Baltimore, USA. TVannor1@jhmi.edu. 4. Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
PURPOSE: This meta-analysis sought to determine whether exercise, psychological, or alternative forms of interventions differentially improve cognitive, physical, and general dimensions of cancer-related fatigue (CRF) in women with a history of breast cancer. METHODS: Databases (PubMed, PsychINFO, EMBASE, and Cochrane Library) were systematically reviewed from inception through March 2019, with data extracted from randomized controlled trials of fatigue interventions using multidimensional CRF outcome measures. Two authors independently assessed methodological quality using the Cochrane Collaboration's risk of bias tool. Analyses were performed with Comprehensive Meta-Analysis (v.3). RESULTS: A total of 471 studies were assessed, of which 11 studies with 12 sets of data involving 1067 patients were included. Across intervention types, small to moderate improvements were observed for cognitive (g = - 0.38), physical (g = - 0.46), and general (g = - 0.45) CRF (p values < 0.01). Exercise produced moderate benefit for cognitive (g = - 0.44), physical (g = - 0.48), and general (g = - 0.49) CRF (p values < 0.01) whereas psychotherapy and disparate forms of alterative interventions were not effective (p values > 0.45). However, a large effect size was observed for a single trial of acupressure across all three CRF dimensions (p < 0.05). CONCLUSIONS: Exercise improved both cognitive and physical aspects of CRF. Further studies should determine the most effective forms, duration, intensity, and methods of supporting exercise in breast cancer patients. Further investigation of acupressure as an intervention for CRF should also be considered.
PURPOSE: This meta-analysis sought to determine whether exercise, psychological, or alternative forms of interventions differentially improve cognitive, physical, and general dimensions of cancer-related fatigue (CRF) in women with a history of breast cancer. METHODS: Databases (PubMed, PsychINFO, EMBASE, and Cochrane Library) were systematically reviewed from inception through March 2019, with data extracted from randomized controlled trials of fatigue interventions using multidimensional CRF outcome measures. Two authors independently assessed methodological quality using the Cochrane Collaboration's risk of bias tool. Analyses were performed with Comprehensive Meta-Analysis (v.3). RESULTS: A total of 471 studies were assessed, of which 11 studies with 12 sets of data involving 1067 patients were included. Across intervention types, small to moderate improvements were observed for cognitive (g = - 0.38), physical (g = - 0.46), and general (g = - 0.45) CRF (p values < 0.01). Exercise produced moderate benefit for cognitive (g = - 0.44), physical (g = - 0.48), and general (g = - 0.49) CRF (p values < 0.01) whereas psychotherapy and disparate forms of alterative interventions were not effective (p values > 0.45). However, a large effect size was observed for a single trial of acupressure across all three CRF dimensions (p < 0.05). CONCLUSIONS: Exercise improved both cognitive and physical aspects of CRF. Further studies should determine the most effective forms, duration, intensity, and methods of supporting exercise in breast cancerpatients. Further investigation of acupressure as an intervention for CRF should also be considered.
Entities:
Keywords:
Breast cancer; Cancer-related fatigue; Fatigue; Interventions; Meta-analysis; Survivorship
Authors: N J Vogelzang; W Breitbart; D Cella; G A Curt; J E Groopman; S J Horning; L M Itri; D H Johnson; S L Scherr; R K Portenoy Journal: Semin Hematol Date: 1997-07 Impact factor: 3.851
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