The Effectiveness of Interventions Based on Symptom Clusters for Symptom Burden and Quality of Life Among Cancer Patients: A Meta-Analysis of Randomized Controlled Trials.

Abstract

Cancer patients suffer severe physical-psychological symptoms presenting as "symptom clusters," causing heavy symptom burden and poor quality of life. Researchers have studied symptom clusters, but whether they could improve symptom burden and quality of life for cancer patients is unclear. Therefore, we aimed to evaluate the effectiveness of interventions based on symptom clusters for symptom burden of different types of clusters and quality of life among cancer patients. A systematic search was performed across six databases from inception to 17 December 2024. The revised Cochrane risk of bias tool was used to check the methodological quality. Data analysis was performed in RStudio, and the intervention effects were explored through a random or fixed effects model. Sensitivity analysis was also performed to evaluate the robustness of the results. We ultimately included nine randomized controlled trials that met the criteria, which were published from 2012 to 2024 and had 998 participants. The results suggested that interventions based on symptom clusters improved symptom burden of mixed symptom clusters (SMD = -0.25, 95% CI [-0.47, -0.04]) and quality of life (SMD = 0.38, 95% CI [0.12, 0.65]), while the relief in symptom burden of physical (SMD = -1.54, 95% CI [-3.34, 0.27]), psychological (SMD = -3.29, 95% CI [-8.09, 1.50]) and gastrointestinal (SMD = -2.24, 95% CI [-4.99, 0.52]) symptom clusters was not significant. To conclude, interventions based on symptom clusters are deemed crucial for improving symptom burden and quality of life among cancer patients. In the future, professionals could tailor interventions considering intervention components and individualized characteristics to further benefit cancer patients. Trial and Protocol Registration: Name: International Prospective Register of Systematic Reviews Number: CRD42023474527.Website link: https://www.crd.york.ac.uk/PROSPERO/#recordDetails.