Effects of yoga interventions on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients: A systematic review.

OBJECTIVE: This systematic review aimed to evaluate the effectiveness of yoga intervention on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. METHODS: Ten electronic databases (Medline, Embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Scopus, British Nursing Index, China National Knowledge Infrastructure, and Wan Fang database) were searched to identify randomized controlled trials from inception to October 2023. Two independent reviewers evaluated study eligibility, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. The findings were synthesized narratively. This systematic review has been registered (PROSPERO ID: CRD42023391269). RESULTS: A total of 1389 studies were identified, and 18 studies were included in this systematic review. Two studies reported significant alleviation of fatigue-pain-sleep disturbance symptoms, and two studies indicated a significant reduction in fatigue-sleep disturbance symptoms compared to the control group. Commonly employed yoga contents included breathing exercise and posture practice. The effective intervention components encompassed the combination of in-person sessions and home-based sessions delivery mode, with intervention sessions lasting 50-120 min each and dosages ranging from once per week to twice daily, spanning 6-16 weeks. CONCLUSIONS: Yoga intervention can be beneficial in alleviating the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. Future research should be tailored to design yoga interventions addressing different treatment stages and preferences of breast cancer patients.

Identifying central symptom clusters and correlates in children with acute leukemia undergoing chemotherapy: a network analysis.

Background: Previous studies have examined symptom clusters in children with acute leukemia, yet a knowledge gap persists regarding central symptom clusters and their influencing factors. By identifying these central clusters and associated factors, healthcare providers can enhance their understanding and effective management of symptoms. Our study seeks to address this gap by identifying symptom clusters, exploring central clusters, and investigating the demographic and health-related factors associated with these clusters in children with acute leukemia undergoing chemotherapy. Methods: A total of 586 children with acute leukemia from January 2021 to April 2023 were recruited from China. They were investigated using Memorial Symptom Assessment Scale 10-18 during chemotherapy. The principal component analysis was used to identify the symptom clusters. An association network was conducted to describe the relationships among symptoms and clusters. A multiple linear model was used to investigate the associated factors for the severity of overall symptoms and each symptom cluster. Results: Five clusters were identified, including oral and skin cluster, somatic cluster, self-image disorder cluster, gastrointestinal cluster and psychological cluster. Gastrointestinal cluster was the most central symptom cluster. Age, sex, clinical classification, number of having chemotherapy and education degree and marital status of the primary caregiver are associated with the severity of these five symptom clusters. Conclusion: Our study highlights the importance of evaluating symptom clusters in children with acute leukemia during chemotherapy. Specifically, addressing gastrointestinal symptoms is crucial for effective symptom management and overall care.

Supportive care needs of patients with colorectal cancer undergoing anticancer therapy: A latent class analysis.

Objective: This study was aimed at identifying the potential subgroups of supportive care needs among Chinese patients with colorectal cancer (CRC) through latent class analysis (LCA) and clarifying the characteristics of patients with high needs. Methods: From January to September 2020, a cross-sectional survey was conducted in the Oncology Department and Radiotherapy Department of four tertiary grade A hospitals in Suzhou by using the general information questionnaire and Comprehensive Needs Assessment Tool for patients with cancer. Potential subgroups of supportive care needs were identified through LCA, and the association between the subgroups and statistical variables was analyzed with chi-square tests to clarify the demographic characteristics of the high-need group. This study was not registered. Results: A total of 403 patients with CRC were included in the survey. LCA indicated two subgroups of supportive care needs in patients with CRC: a high-need group (51.86% of patients) and a low-need group (48.14% patients). In both groups, the probability of healthcare staff and information needs was high (> 50%). Single/divorced/widowed patients had greater supportive care needs than married patients, and patients with rectal cancer had greater supportive care needs than those with colon cancer. Conclusions: Patients' healthcare staff and information needs are of critical importance. Focus should be placed on unmarried, patients with rectal cancer, as well as those receiving chemotherapy plus radiotherapy or palliative treatment.

Which Exercise Approaches Work for Relieving Cancer-Related Fatigue? A Network Meta-analysis.

OBJECTIVE: To determine the most effective exercise modalities for managing cancer-related fatigue during and after cancer treatment. DESIGN: Network meta-analysis (NMA) of randomized controlled trials. LITERATURE SEARCH: Seven electronic databases were systematically searched from inception to January 2022. STUDY SELECTION CRITERIA: Randomized controlled trials testing the effects of exercise on relieving cancer-related fatigue in adult patients with cancer. DATA SYNTHESIS: An NMA of 56 studies was conducted, and the PRISMA-NMA guidelines were followed when reporting results. To determine the most effective interventions, the surface under the cumulative ranking curve (SUCRA) value was calculated for each exercise modality. RESULTS: Combined aerobic and resistance exercise (standardized mean difference [SMD], 1.57; credible interval [CrI], 1.03-2.10), yoga (SMD, 1.02; CrI: 0.44, 1.60), and regular physical activity (SMD, 1.07; CrI: 0.21, 1.92) could significantly alleviate cancer-related fatigue compared to control groups (usual care, wait-list, and regular physical activity). Combined aerobic and resistance exercise (SUCRA, 97.2%) had the highest probability of efficacy, followed by yoga (SUCRA, 75.5%) and regular physical activity (SUCRA, 74.1%). During cancer treatment, combined aerobic and resistance exercise (SUCRA, 94.5%) ranked first in efficacy, followed by regular physical activity (SUCRA, 82.1%) and yoga (SUCRA, 73.8%). After cancer treatment, only combined aerobic and resistance exercise (SMD, 0.99; CrI: 0.13, 1.84) had a significant effect on cancer-related fatigue. CONCLUSION: Combined aerobic and resistance exercise, yoga, and regular physical activity were the most effective exercise modalities for alleviating cancer-related fatigue. Combined aerobic and resistance exercise is recommended during and after cancer treatment. J Orthop Sports Phys Ther 2023;53(6):1-10. Epub: 23 March 2023. doi:10.2519/jospt.2023.11251.

Effectiveness comparisons of various psychosocial therapies for cancer-related fatigue: A Bayesian network meta-analysis.

OBJECTIVES: The purpose of this network meta-analysis (NMA) is to compare the effect of several psychosocial therapies on CRF critically. METHODS: We applied systematic strategies based on eight databases, namely the Cochrane Central Register of Controlled Trials, PubMed, Embase, PsycINFO, China Biology Medicine (CBM), Wan Fang database, VIP, and China National Knowledge Infrastructure (CNKI) database to preliminary literature retrieval to identify relevant randomized controlled trials (RCTs). Studies, including adult patients (≥18 years) diagnosed with cancer, were eligible regardless of cancer stage and current treatment. We carried out an expression analysis for comparing the efficacy of various psychosocial therapies using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. RESULTS: We identified 41 RCTs including six different psychosocial interventions (4422 participants), namely cognitive-behavioral therapy (CBT), mindfulness-based stress reduction therapy (MBSR), psychoeducational therapy (PE), stress management therapy (SMT), meditation therapy (MT) and comprehensive therapy (CT). Our NMA results showed that three psychosocial intervention therapies were effective for CRF in cancer patients. The most effective psychosocial intervention was MBSR (SMD = -1.23, CrI: -1.88, -0.59, SUCRA = 83.33%), followed by PE (SMD = -0.86, CrI: -1.53, -0.18, SUCRA = 58.51%) and CBT (SMD = -0.84, CrI: -1.31, -0.37, SUCRA = 57.67%). CONCLUSIONS: Our study showed that MBSR was most likely to be the best psychosocial intervention to relieve CRF in cancer patients. Medical staff should pay attention to applying MBSR to cancer patients in future clinical care.

Effects of Home-Based Walking on Cancer-Related Fatigue in Patients With Breast Cancer: A Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: This study was designed to critically evaluate the effect of home-based walking on cancer-related fatigue (CRF) in patients with breast cancer (BC) receiving anticancer treatment. DATA SOURCES: Eight databases were systematically searched from inception to March 2021 for randomized controlled trials (RCTs) without language restrictions. STUDY SELECTION: Two reviewers (Y.Y. and Z.N.) scanned the titles and abstracts and then read the full texts of potentially eligible trials to screen the literature. Inclusion criteria were studies of home-based walking (HBW) intervention in adult patients with BC, using fatigue as a primary or secondary outcome, and containing extractable fatigue scores. DATA EXTRACTION: Two reviewers (Y.Y. and Z.N.) critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form. The standardized mean difference (SMD) was used when the outcome assessment tools were different. All of the analyses were performed using Review Manager 5.3. DATA SYNTHESIS: Eight RCTs including 764 patients (HBW: 377, control: 387) meeting the inclusion criteria for the meta-analysis were identified. HBW had a significant effect on CRF in patients with BC receiving multiple anticancer treatments (SMD=-0.61; 95% confidence interval [CI], -0.86 to -0.36; P<.001). HBW without other exercises (SMD=-0.83; 95% CI, -1.39 to -0.27; P=.003), walking for a gradually increased duration (SMD=-1.24; 95% CI, -2.20 to -0.28; P=.010), and no restrictions on walking intensity (SMD=-1.03; 95% CI, -1.75 to -0.31; P=.005) demonstrated substantial effects on CRF. Of the 8 included studies, only 3 reported adverse events. CONCLUSIONS: HBW can be considered as an alternative therapy for relieving CRF in patients with BC undergoing anticancer treatment.

Wrist-ankle acupuncture has a positive effect on cancer pain: a meta-analysis.

BACKGROUND: Wrist-ankle acupuncture (WAA) as a kind of micro acupuncture therapy has been used to management cancer pain, however, the effects of WAA on cancer pain were controversial in the current studies. Therefore, the purpose of this meta-analysis was to critically evaluate the effect of wrist-ankle acupuncture (WAA) on cancer pain. METHODS: Seven digital databases were searched from the inception of databases to July 2020, including CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed and Embase. Randomized controlled trials conforming to the inclusion and exclusion criteria were screened and extracted; the risk of bias was evaluated using the Cochrane Collaboration criteria. The primary outcome indicators included pain relief rate and pain score, and the secondary outcome was adverse reaction incidence. All analyses were performed with Review Manager 5.3. RESULTS: A total of 13 studies with 1005 cancer patients (intervention group: 568, control group: 437) were included in this meta-analysis. The results demonstrated that the pain relief rate of experimental group (WAA / WAA + drug intervention) was better than that of control group (analgesic drug intervention), and the difference was statistically significant [RR = 1.31, 95%CI: 1.15 ~ 1.49, P < 0.01]. CONCLUSIONS: WAA has certain effect on cancer pain, and the effect of WAA combined with pharmacological intervention is better than that of drug therapy alone.

Music interventions can alleviate cancer-related fatigue: a metaanalysis.

PURPOSE: This study was designed to critically evaluate the effect of music interventions on cancer-related fatigue (CRF) in cancer patients. METHODS: Seven databases (Cochrane Library, PubMed, Embace, CBM, Wanfang, VIP, and CNKI) were systematically reviewed from inception to June 2020 for randomized controlled trials (RCTs). Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. All analyses were performed with Review Manager 5.3. RESULTS: A total of 8 qualified studies that included 467 patients (music interventions: 235, control: 232) were included. Cancer patients who completed adjuvant therapy in the music intervention group, especially those with malignant hematological diseases, reported reduced CRF levels compared with patients undergoing routine care. Regardless of the frequencies, music interventions can relieve fatigue in cancer patients. Providing prerecorded music and participating in live music both can mitigate CRF. CONCLUSIONS: Music interventions can be considered as an alternative therapy for relieving fatigue in cancer patients who are undergoing active treatment or have completed treatment.