Data were retrieved from the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium. Potential moderators were studied with meta-analyses of pooled individual patient data from 14 randomized controlled trials through linear mixed-effects models with interaction tests. The analyses were conducted separately in patients with breast (n = 1091) and prostate cancer (n = 1008).
Statistically significant, small overall effects of psychosocial interventions on fatigue were found (breast cancer: β = -0.19 [95% confidence interval (95%CI) = -0.30; -0.08]; prostate cancer: β = -0.11 [95%CI = -0.21; -0.00]). In both patient groups, intervention effects did not differ significantly by sociodemographic or clinical characteristics, nor by baseline levels of fatigue or pain. For intervention-related moderators (only tested among women with breast cancer), statistically significant larger effects were found for cognitive behavioral therapy as intervention strategy (β = -0.27 [95%CI = -0.40; -0.15]), fatigue-specific interventions (β = -0.48 [95%CI = -0.79; -0.18]), and interventions that only targeted patients with clinically relevant fatigue (β = -0.85 [95%CI = -1.40; -0.30]).
Our findings did not provide evidence that any selected demographic or clinical characteristic, or baseline levels of fatigue or pain, moderated effects of psychosocial interventions on fatigue. A specific focus on decreasing fatigue seems beneficial for patients with breast cancer with clinically relevant fatigue.
数据来自预测最佳康复和支持性护理(POLARIS)联盟。通过具有相互作用测试的线性混合效应模型,对来自14项随机对照试验的汇总个体患者数据进行荟萃分析,研究了潜在的调节者。分别在乳腺癌(n=1091)和前列腺癌(n=1008)患者中进行分析。
具有统计学意义,发现心理社会干预对疲劳的总体影响较小(乳腺癌:β=-0.19[95%置信区间(95CI)=-0.30;-0.08];前列腺癌:β=-0.11[95CI=-0.21;-0.00]).在两组患者中,干预效果在社会人口统计学或临床特征上没有显著差异,也不包括疲劳或疼痛的基线水平。对于与干预相关的主持人(仅在患有乳腺癌的女性中进行了测试),认知行为疗法作为干预策略具有统计学意义(β=-0.27[95CI=-0.40;-0.15]),针对疲劳的干预措施(β=-0.48[95CI=-0.79;-0.18]),以及仅针对临床相关疲劳患者的干预措施(β=-0.85[95CI=-1.40;-0.30])。
我们的发现没有提供证据表明任何选定的人口统计学或临床特征,或基线水平的疲劳或疼痛,心理社会干预对疲劳的调节作用。特别关注减少疲劳似乎对患有临床相关疲劳的乳腺癌患者有益。