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Abstract：
Psychosocial interventions can reduce cancer-related fatigue effectively. However, it is still unclear if intervention effects differ across subgroups of patients. These meta-analyses aimed at evaluating moderator effects of (a) sociodemographic characteristics, (b) clinical characteristics, (c) baseline levels of fatigue and other symptoms, and (d) intervention-related characteristics on the effect of psychosocial interventions on cancer-related fatigue in patients with non-metastatic breast and prostate cancer.
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.
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.
摘要：
心理社会干预可以有效减少癌症相关性疲劳。然而,目前尚不清楚不同亚组患者的干预效果是否不同.这些荟萃分析旨在评估(A)社会人口统计学特征的调节效应，(b)临床特征，(c)疲劳和其他症状的基线水平，(d)非转移性乳腺癌和前列腺癌患者的心理社会干预对癌症相关性疲乏影响的干预相关特征。
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。
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。
