Efficacy of Cognitive Training for Treating Cancer-related Cognitive Impairment: Systematic Review and Meta-analysis...

Cognitive Training (CT) is proposed to improve cancer-related cognitive impairment (CRCI), but its effect on objective cognition remains unclear. This systematic review and meta-analysis (PROSPERO ID: CRD42023426761) aimed to examine the efficacy of CT on objective CRCI using neuropsychological tests categorised into cognitive domains following international classifications. Secondary objectives were to assess CT effects on self-reported variables. A systematic search was conducted in PubMed, PsycINFO and Cochrane Library (last search in May 2024). Controlled trials performing CT and reporting neuropsychological outcomes were included. Risk of bias was assessed with RoB-2 and certainty of evidence with the GRADE approach. Hedges' g at post-intervention was the primary outcome of the multivariate meta-analysis, calculated as the standardized mean difference between groups at post-intervention. Hedges´ g at pre-intervention was included as a fixed covariate. Fifteen studies were included in the systematic review and 12 in the meta-analysis (control group n = 507; intervention group n = 578). The meta-analysis showed a small, significant effect of CT on executive functioning (Hedges' g = 0.15, 95% CI [0.00, 0.29], p = .047). This result warrants cautious interpretation due to low-quality evidence. No significant effects were found in other cognitive domains or self-reported indices. Although these results contrast with previous meta-analyses, this study includes a larger dataset, enhancing the robustness of the results, and introduces a novel analysis strategy by grouping neuropsychological tests according to international classifications. In conclusion, CT shows a small benefit for executive functioning in CRCI, but high-quality studies are needed to confirm its efficacy.