Zhang Meiyun, Huang Lihua, Feng Zhixian, Shao Lewen, Chen Lixia
Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China -
Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Minerva Med. 2017 Feb;108(1):84-93. doi: 10.23736/S0026-4806.16.04528-6. Epub 2016 Sep 16.
Cognitive behavioral therapy (CBT) has been shown to be effective in mitigating various psychosocial impacts from breast cancer. Long-term studies have yielded mixed findings on the outcome of CBT in breast cancer settings, especially with respect to quality of life (QOL) and the quantified degree of stress (QDS).
Medline, Cochrane, Embase, and Google Scholar databases were searched and randomized controlled trials relevant to the use of CBT and its variants in breast cancer patients were selected, and their pooled results meta-analyzed.
Six studies qualified for inclusion in the meta-analysis. Results from the six pooled studies did not demonstrate that CBT improves QOL (standardized mean difference =-0.016, 95% CI=-0.898 to 0.866, P=0.972) or reduces QDS (standardized mean difference =-0.125, 95% CI=-0.268 to 0.017, P=0.084) for breast cancer survivors. However, interpretation of these results requires caution, given the small number of eligible studies, comprising a total of only 430 patients. Since the literature also includes trials of CBT combined with various other therapies, including hypnosis, exercise treatment, and stress management, with promising results in breast cancer settings, expanded clinical research is likely to demonstrate an overall benefit of CBT.
Despite the meta-analysis fails to support the use of CBT to improve QOL or reduce stress for breast cancer survivors, CBT appears to be promising as a therapeutic intervention against many of the psychosocial impacts of breast cancer.
认知行为疗法（CBT）已被证明在减轻乳腺癌带来的各种心理社会影响方面是有效的。长期研究对于乳腺癌环境中CBT的结果得出了不一致的发现，特别是在生活质量（QOL）和量化应激程度（QDS）方面。
检索了Medline、Cochrane、Embase和谷歌学术数据库，并选择了与在乳腺癌患者中使用CBT及其变体相关的随机对照试验，并对其汇总结果进行荟萃分析。
六项研究符合纳入荟萃分析的条件。六项汇总研究的结果并未表明CBT能改善乳腺癌幸存者的生活质量（标准化均数差=-0.016，95%CI=-0.898至0.866，P=0.972）或降低量化应激程度（标准化均数差=-0.125，95%CI=-0.268至0.017，P=0.084）。然而，鉴于符合条件的研究数量较少，总共只有430名患者，对这些结果的解释需要谨慎。由于文献中还包括CBT与各种其他疗法（包括催眠、运动治疗和压力管理）相结合的试验，在乳腺癌环境中取得了有希望的结果，扩大的临床研究可能会证明CBT的总体益处。
尽管荟萃分析未能支持使用CBT来改善乳腺癌幸存者的生活质量或减轻压力，但CBT作为一种针对乳腺癌许多心理社会影响的治疗干预措施似乎很有前景。
