Effects of non-pharmacological interventions on cancer-related cognitive impairment in patients with breast cancer: A systematic review and network meta-analysis

Purpose:
To compare and rank the effectiveness of non-pharmacological interventions on cancer-related cognitive impairment (CRCI) for breast cancer patients.

Methods:
A systematic review and network meta-analysis were conducted following PRISMA guidelines. Randomized controlled trials from January 1, 2000 to October 11, 2024 were searched in nine electronic databases. Studies involving non-pharmacological interventions for managing CRCI in breast cancer were included. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias 2 assessment tool. Stata 15 was used for data analysis.

Results:
A total of 42 eligible studies were identified, covering eight non-pharmacological interventions. Psychological interventions (98.7%), Tai Chi/Qigong/Baduanjin (74.5%), and cognitive rehabilitation (70.1%) were the three most effective methods to improve subjective cognition. Cognitive training showed the highest effectiveness for working memory and executive function, with effectiveness rates of 78.3% and 83.4%, respectively. Cognitive rehabilitation (87.1%) was also the most effective for learning memory., while meditation/mindfulness-based stress reduction (71.8%) led in processing speed.

Conclusions:
This network meta-analysis found that psychological interventions was the most effective for improving subjective outcomes. cognitive training proved most effective for working memory and executive function, while cognitive rehabilitation was most effective in enhancing learning memory, and meditation/mindfulness-based stress reduction ranked highest for processing speed.

Keywords: Breast patients; Cancer-related cognitive impairment; Network meta-analysis; Non-pharmacological interventions; Systematic review.

PMID: 39919600 DOI: 10.1016/j.ejon.2025.102804