Lin Lee-Yuan, Tam Ka-Wai, Huang Tsai-Wei
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
J Psychosom Res. 2023 Nov;174:111501. doi: 10.1016/j.jpsychores.2023.111501. Epub 2023 Sep 27.
Cancer-related fatigue (CRF) is a common side effect in cancer patients, possibly due to disrupted circadian rhythms. While bright light therapy (BLT) is known to modulate circadian rhythms, its role in mitigating CRF remains unclear. This study examined the impact of BLT on CRF and other related symptoms.
PubMed, Embase, Cochrane Library, and SCOPUS databases were searched. The trials were selected according to the PRISMA guidelines. The severity and quality of CRF and related symptoms were investigated in post-BLT intervention.
Twelve trials involving 691 were included. BLT significantly reduced CRF (SMD = -0.92, 95% CI: -1.45 to -0.40, p < 0.00001, I = 90%) and insomnia (SMD = -2.80, 95% CI: -4.61 to -0.98, I = 0%). Subgroup analyzes were performed based on various factors including light illuminance and intervention duration. BLT was found to be effective in both preventing and treating CRF, though it did not significantly enhance sleep quality, depression, and quality of life (QoL).
BLT is a promising intervention for managing CRF in cancer patients. Its efficacy in improving sleep quality, and insomnia, reducing depression, and enhancing QoL requires further exploration. A 4-week BLT intervention with ≥10,000 lx is recommended for preventing and treating CRF, with longer or less intense interventions also showing effectiveness. Otherwise, BLT exhibited minimal adverse effects.
癌症相关疲劳（CRF）是癌症患者常见的副作用，可能是由于昼夜节律紊乱所致。虽然已知强光疗法（BLT）可调节昼夜节律，但其在减轻CRF方面的作用仍不明确。本研究探讨了BLT对CRF及其他相关症状的影响。
检索了PubMed、Embase、Cochrane图书馆和SCOPUS数据库。根据PRISMA指南选择试验。在BLT干预后，对CRF及相关症状的严重程度和质量进行了调查。
纳入了12项试验，共691例患者。BLT显著降低了CRF（标准化均数差[SMD]= -0.92，95%可信区间[CI]：-1.45至-0.40，p < 0.00001，I² = 90%）和失眠（SMD = -2.80，95%CI：-4.61至-0.98，I² = 0%）。基于光照强度和干预持续时间等各种因素进行了亚组分析。发现BLT在预防和治疗CRF方面均有效，尽管它并未显著提高睡眠质量、减轻抑郁和改善生活质量（QoL）。
BLT是一种有前景的用于管理癌症患者CRF的干预措施。其在改善睡眠质量、失眠、减轻抑郁和提高QoL方面的疗效需要进一步探索。建议采用≥10000勒克斯的4周BLT干预来预防和治疗CRF，更长或强度较低的干预也显示出有效性。此外，BLT的不良反应极小。
