TY - JOUR
T1 - Interventions for multidimensional aspects of breast cancer-related fatigue
T2 - a meta-analytic review
AU - Vannorsdall, Tracy D.
AU - Straub, Ermiece
AU - Saba, Christina
AU - Blackwood, Mallory
AU - Zhang, Jingyi
AU - Stearns, Keren
AU - Smith, Karen Lisa
N1 - Funding Information:
The study was funded by the Under Armour Women's Health and Breast Cancer Innovation Grant, the Johns Hopkins Catalyst Award, and the Robert L. Sloan Fund for Cancer Research.
Funding Information:
Dr. Smith holds stock in ABT Labs and Abbvie. Dr. Smith also receives institutional research support from CancerIncite and Pfizer. The remaining authors declare that they have no conflict of interest.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/4
Y1 - 2021/4
N2 - 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.
AB - 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.
KW - Breast cancer
KW - Cancer-related fatigue
KW - Fatigue
KW - Interventions
KW - Meta-analysis
KW - Survivorship
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U2 - 10.1007/s00520-020-05752-y
DO - 10.1007/s00520-020-05752-y
M3 - Review article
C2 - 33089371
AN - SCOPUS:85093121940
SN - 0941-4355
VL - 29
SP - 1753
EP - 1764
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 4
ER -