Cognitive Stimulation Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients: A Systematic Review and Meta-Analysis.

Abstract

Background: A considerable proportion of breast cancer (BC) patients experience chemotherapy-related cognitive impairment (CRCI) and other symptoms even after the completion of treatment. The persistence of CRCI throughout the oncological process highlights the need for routine assessment of its severity, impact on quality of life, and the effectiveness of interventions aimed at addressing it. Objectives: To analyse the effectiveness of cognitive stimulation interventions on CRCI in BC patients and to identify the characteristics of such interventions, including the most appropriate timing for their implementation, the most suitable techniques, and their duration. Methodology: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Randomized controlled trials published between 1 January 2020 and 31 December 2024 were searched across three electronic databases. Studies involving cognitive stimulation interventions for the management of CRCI in BC patients were included. Results: A total of 12 eligible studies were identified for the systematic review and 10 for the meta-analysis. The review revealed a wide range of cognitive stimulation interventions, differing in techniques, duration, format, and timing of implementation. Group-based therapies lasting between 6 and 12 weeks predominated, with cognitive outcomes primarily assessed using the FACT-Cog scale. The meta-analysis demonstrated a moderate positive effect of cognitive stimulation interventions on cognitive functioning in BC patients (d = 0.59), although not statistically significant (p = 0.07), and showed high heterogeneity across studies (I² = 93%). Conclusions: Cognitive stimulation interventions show potential benefits in improving cognitive functioning in BC patients following chemotherapy. However, the high methodological heterogeneity limits the strength of the evidence. Further research is needed to develop standardized and personalized early intervention protocols.