Using Integrative Therapies to Improve Patient-Reported Outcomes in Breast Cancer Survivors: A Living Evidence-Based Clinical Practice Guideline

IF 3.6 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Evidence‐Based Medicine Pub Date : 2025-04-10 DOI:10.1111/jebm.70029

Tingting Lu, Honghao Lai, Hongsheng Lin, Fei Ma, Li Hou, Lili Tang, Yi Zhu, Huijuan Mao, Anthony Lin Zhang, Myeong Soo Lee, Akihiko Ozaki, Mariana Cabral Schveitzer, Hui Zhao, Lidan Zhong, Baohui Jia, Lei Fan, Jiajie Huang, Baojin Han, Weilong Zhao, Long Ge, Jie Liu, Luqi Huang

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Abstract

Aim

Breast cancer imposes a serious disease and economic burden on patients. This guideline aims to develop a living evidence-based clinical practice recommendations to guide the use of integrative therapies for the improvement of patient-reported outcomes (PROs) in breast cancer survivors.

Methods

We searched systematic reviews and meta-analyses or conducted de nova systematic reviews and meta-analyses to support the recommendations. The grading of recommendations, assessment, development, and evaluation approach was used to rate the certainty of evidence and the strength of recommendations.

Results

The guideline panel issued 17 recommendations: for alleviating anxiety, strong recommendations in favor of muscle relaxation training, yoga, acceptance and commitment therapy, cognitive behavioral therapy, psychological education, and Tai Chi in general breast cancer survivors; for alleviating depression, strong recommendations in favor of mindfulness therapy, cognitive behavioral therapy, group psychotherapy, muscle relaxation training, acceptanceand commitment therapy in general breast cancer survivors, and exercise intervention for patients received radiotherapy; for sleep quality, conditional recommendations for all therapies; for pain, strong recommendations in favor of exercise intervention for postoperative breast cancer survivors; for alleviating fatigue, strong recommendations in favor of mindfulness therapy and group psychotherapy in general breast cancer survivors; for improving the quality of life, strong recommendations in favor of mindfulness therapy in general breast cancer survivors, Baduanjin and exercise intervention for patients undergoing anticancer treatment.

Conclusion

This proposed guideline provides recommendations for improving the PROs of breast cancer survivors. We hope these recommendations can help support practicing physicians and other healthcare providers for breast cancer survivors.

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使用综合疗法改善乳腺癌幸存者患者报告的结果：一个活生生的循证临床实践指南

目的乳腺癌给患者带来了严重的疾病和经济负担。本指南旨在制定一个活生生的循证临床实践建议，以指导综合疗法的使用，以改善乳腺癌幸存者患者报告的预后（PROs）。方法我们检索系统综述和荟萃分析，或进行全新的系统综述和荟萃分析来支持这些建议。建议、评估、发展和评价方法的分级用于评价证据的确定性和建议的强度。结果：指南小组发布了17项建议：缓解焦虑，强烈建议对一般乳腺癌幸存者进行肌肉放松训练、瑜伽、接受和承诺疗法、认知行为疗法、心理教育和太极拳；对于缓解抑郁，强烈推荐正念疗法、认知行为疗法、团体心理治疗、肌肉放松训练、接受和承诺疗法，以及对接受放疗的患者进行运动干预；对于睡眠质量，有条件地推荐所有疗法；对于疼痛，强烈建议乳腺癌术后幸存者进行运动干预；对于缓解疲劳，强烈建议对一般乳腺癌幸存者进行正念疗法和团体心理治疗；在改善生活质量方面，强烈建议对一般乳腺癌幸存者进行正念疗法，对接受抗癌治疗的患者进行八段筋和运动干预。结论：本指南为提高乳腺癌幸存者的pro提供了建议。我们希望这些建议可以帮助支持执业医生和其他医疗保健提供者为乳腺癌幸存者。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.