Exercise and mind-body therapies for fatigue in breast cancer: evidence mapping from systematic reviews

Cancer-related fatigue (CRF) is a common side effect in patients with breast cancer. Various non-pharmacological interventions are employed to alleviate CRF; however, current research lacks evaluations of their efficacy. This study compared the effectiveness of different non-pharmacological interventions on CRF in patients with breast cancer and to provide references for future research and clinical practice.

We systematically searched multiple databases, including the China National Knowledge Infrastructure (CNKI), Wanfang, VIP Database for Chinese Technical Periodicals (VIP), China Biology Medicine (CBM), PubMed, Web of Science, Cochrane Library and EMBASE, covering the period from the inception of each database to August 2024. The quality of the included studies was assessed via the AMSTAR-2 scale (a measurement tool to assess systematic reviews 2), and evidence mapping was used to summarise the characteristics of included studies.

52 systematic reviews/meta-analyses were included. The types of non-pharmacological interventions included 34 exercise interventions, 6 multidimensional interventions (a multimodal intervention approach involving three or more non-pharmacological therapies), 4 psychosocial interventions, 2 massage or acupuncture therapies, 2 art therapies, 1 moxibustion, 1 dietary supplement, 1 continuity of care and 1 systemic care. The conclusions of these studies were categorised as 'beneficial' for 41 studies, 'may be beneficial' for 9 studies and 'inconclusive' for 2 studies.

The evidence mapping revealed that exercise interventions are the most widely used and effective interventions for CRF in patients with breast cancer. However, owing to the variety of non-pharmacological interventions and the fact that some of them are less common in studies, more large-sample, high-quality, prospective randomised trials and systematic reviews/meta-analyses involving different interventions are needed to further validate them in the future.