Non-pharmacologic interventions for treating fear of cancer recurrence in patients with cancer: A network meta-analysis of randomized controlled trials

Abstract

Objective

This study aimed to evaluate the impact of non-pharmacological interventions on fear of cancer recurrence in patients with cancer by synthesizing evidence from various studies using the net meta-analysis (NMA) approach. Additionally, the study sought to rank the efficacy of these interventions.

Methods

Two investigators independently searched the PubMed, Cochrane Library, Embase, and Web of Science databases to identify randomized controlled trials(RCTs) that met the inclusion criteria. The search encompassed the period from the inception of the database to December 2023. The included studies were then subjected to a quality assessment, and a network meta-analysis was performed to evaluate and compare the effectiveness of the interventions.

Results

This study included 27 RCTs involving 3009 patients and examined seven types of non-pharmacological interventions. The NMA results indicated that, based on the Surface Under the Cumulative Ranking curve, Cancer and Living Meaningfully (CALM) was the most effective intervention (100 %), followed by Mindfulness Therapy (MT) at 76.5 % and Couples' Skills Training (CST) at 60.6 %. However, the league table results showed that, compared to the waitlist group, the effects of CALM [SMD = −4.83, 95 % CI (−5.93, −3.73)] and CST [SMD = −0.86, 95 % CI (−1.65, −0.07)] were significant, while MT [SMD = −1.52, 95 % CI (−3.46, 0.43)] did not reach statistical significance. Furthermore, CST was more effective than Cognitive Behavioral Therapy [SMD = −2.98, 95 % CI (−5.40, −0.56)].

Conclusion

The results of this study indicate that CALM is the most effective intervention for addressing mental health issues.