Central Michigan University College of Medicine, Saginaw, Michigan, USA.
The University of Texas at Austin Steve Hicks School of Social Work, Austin, Texas, USA.
Cancer Med. 2024 Aug;13(16):e70063. doi: 10.1002/cam4.70063.
It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta-analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy.
In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression (for moderator analysis).
Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294-0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population.
CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention-related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer.
长期以来，认知行为疗法（CBT）对改善普通人群的心理健康（MH）和生活质量（QoL）有积极影响已得到充分证实，但针对癌症幸存者的研究仍然有限，尤其是对 QoL 结果的研究。本荟萃分析的目的是调查 CBT 与对照组相比对癌症患者 MH 和 QoL 结果的影响。在本研究中，对照组定义为标准疗法、等候名单对照和积极/替代疗法。
共收集了 154 项临床试验，样本量为 1627 人。针对 MH 和 QoL 的分析排除了 29 项临床试验，最终分析了 132 项临床试验（和 1030 个效应量）。使用 R 统计软件（版本 4.2.2）和 robumeta 包完成分析，其中包括仅截距元回归中的稳健方差估计（RVE）和单变量元回归（用于调节分析）。
在 132 项临床试验和 1030 个效应量估计中，我们发现 CBT 可适度改善癌症患者的 MH 和 QoL，d 值为 0.388，95%CI 为 0.294-0.483，p<0.001。此外，年龄和交付格式可能会影响 CBT 在该患者群体中的疗效。
CBT 在统计学上改善了癌症患者的 MH 和 QoL 心理社会参数，在年轻患者中的疗效更大。当肿瘤学家考虑将 CBT 作为癌症患者的心理治疗干预时，应考虑重要的临床和干预相关因素，即年龄和交付方式。
