Physical Therapies for Psychosomatic Symptoms and Quality of Life Induced by Aromatase Inhibitors in Breast Cancer Patients: A Systematic Review and Meta-Analysis.

Autor:	Zhu XY; Department of Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Li Z; Department of Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Chen C; Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Feng RL; Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Cheng BR; Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Liu RY; Department of Encephalopathy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Wang RT; Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Xu L; Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China., Wang Y; Graduate School of Beijing University of Chinese Medicine, Beijing, China., Tao X; School of Medical Humanities, Capital Medical University, Beijing, China., Zhao P; Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2021 Nov 12; Vol. 11, pp. 745280. Date of Electronic Publication: 2021 Nov 12 (Print Publication: 2021).
DOI:	10.3389/fonc.2021.745280
Abstrakt:	Objective: To evaluate the effects of Physical Therapies (PTs) on improvement in psychosomatic symptoms and quality of life (QOL) in breast cancer patients. Data Sources: Seven databases (MEDLINE, EMBASE, Cochrane CENTRAL, China National Knowledge Infrastructure, Wangfang, VIP, and China Biology Medicine disc databases) were systematically searched from the database inception through May 18, 2021. Study Selection: Randomized controlled trials (RCTs) which compared acupuncture or exercise with a sham control or usual care for the treatment of aromatase inhibitors (AIs)-related psychosomatic symptoms and QOL. Data Extraction and Synthesis: Data were screened and extracted independently using predesigned forms. The quality of RCTs was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. The effect size was calculated via random-effects modeling. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Main Outcomes and Measures: The score of pain was measured with BPI scale and Western Ontario and the McMaster Universities Index (WOMAC) scale. Emotional state was measured with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS-A), and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). The QOL score was measured by self-reported measurements, including the Functional Assessment of Cancer Therapy-General (FACT-G) scale and 36-Item Short Form Survey (SF-36) scale. Results: Eleven RCTs (with 830 patients) were included in the systematic review, and data from 10 RCTs (with 798 patients) were used in the meta-analysis. Results showed acupuncture significantly reduced worst pain scores ( P < 0.00001, I ² = 83.5%) [SMD = -0.81, 95% CI (-1.51, -0.11)], but the effect of exercise therapies was not significant in overall change in worst pain scores ( P =0.006, I ² = 72.3%) [SMD = -0.30, 95% CI (-0.76, 0.16)]. Both acupuncture and exercise resulted in little to no difference in overall change in HADS-A subscale (P = 0.026<0.05, I ² = 79.8%) [WMD = -0.21, 95% CI (-3.44, 3.03)], PSQI subscale (P = 0.488, I ² = 0%) [WMD = 0.98, 95% CI (-0.57, 2.53)], and FACIT-Fatigue subscale (P = 0.022<0.05, I ² = 81.0%) [WMD = 1.6, 95% CI (-5.75, 8.94)]. Exercise (compared with usual care) was associated with improving overall change in health-related QOL (subscales of SF-36 tool) (P = 0, I ² = 72.1%) [WMD = 7.97, 95% CI (5.68, 10.25)] and cancer-specific QOL (subscales of FACT-G tool) (P = 0.304, I ² = 16%) [WMD = 1.16, 95% CI (0.34, 1.97)]. Conclusions and Relevance: This systematic review and meta-analysis suggested that based on moderate-level evidence, acupuncture was associated with significant reductions in pain intensity, and exercise might improve QOL in breast cancer patients treated with AIs. However, in psychosomatic symptoms such as anxiety, sleep disturbance, and fatigue, acupuncture and exercise training did not result in significant improvements. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Zhu, Li, Chen, Feng, Cheng, Liu, Wang, Xu, Wang, Tao and Zhao.)
Databáze:	MEDLINE
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