The impact of psychosocial intervention on survival in cancer: a meta-analysis
The impact of psychosocial intervention on survival in cancer: a meta-analysis
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DOI：
10.21037/apm.2016.03.06
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发表时间：
2016-04-01
影响因子：
--
通讯作者：
Chow, Edward
中科院分区：
文献类型：
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作者：
Fu, Wayne W.;Popovic, Marko;Chow, Edward
背景：社会心理干预对癌症患者生存率的影响仍然存在争议。最近的文献进行了荟萃分析，以评估潜在的生存益处与心理社会干预癌症patient.Methods：MEDLINE，EMBASE，和科克伦中央检索从2004年1月至2015年5月的所有随机对照试验（RCT），比较癌症患者接受心理社会干预和接受其他干预，或没有干预之间的生存结果。终点包括1年、2年和4年总生存率。亚组分析进行比较组与个人交付的干预措施，并评估乳腺癌只有trials.Results：在5,080识别的文章，13项试验被纳入分析。干预组在1年[风险比（RR）=0.82; 95%置信区间（CI），0.67-1.00; P=0.04]和2年（RR=0.86; 95% CI，0.78-0.95; P=0.003）时有显著的生存获益。然而，在4年时未检测到显著差异（RR=0.94; 95%CI，0.85-1.04; P=0.24）。在乳腺癌患者中，心理社会干预在一年内有显著的生存益处（RR=0.59; 95% CI，0.42-0.82; P=0.002），但2年时无差异（RR=0.82; 95% CI，0.67-1.02; P=0.07）或4年（RR=0.95; 95% CI，0.73-1.23; P=0.68）。一年时，组间干预有显著的生存获益，有利于干预组（RR=0.57; 95% CI，0.41-0.79; P=0.0008），但2年时无差异（RR=0.84; 95% CI，0.68-1.02; P=0.08）或4年（RR=0.94; 95% CI，0.75-1.20; P=0.64）。单独实施干预在一年内没有显著的生存益处（RR=0.92; 95% CI，0.791.08; P=0.32），2年（RR=0.87; 95% CI，0.75-1.00; P=0.05）或4年（RR=0.93; 95%CI，0.84-1.04; P=0.21）.结论：对于主要分析和分组治疗，心理社会干预仅显示短期的生存改善。单独提供的干预措施未能显示出任何生存益处。未来的研究需要更长的随访时间来研究长期生存结局。
Background: The impact of psychosocial interventions on survival remains controversial in patients with cancer. A meta-analysis of the recent literature was conducted to evaluate the potential survival benefit associated with psychosocial interventions for cancer patients.Methods: MEDLINE, EMBASE, and Cochrane Central were searched from January 2004 to May 2015 for all randomized controlled trials (RCTs) that compared survival outcomes between cancer patients receiving a psychosocial intervention and those receiving other, or no interventions. Endpoints included one-, two-, and four-year overall survival. Subgroup analyses were performed to compare group-versus individually-delivered interventions, and to assess breast cancer-only trials.Results: Of 5,080 identified articles, thirteen trials were included for analysis. There was a significant survival benefit for the intervention group at one year [risk ratio (RR)=0.82; 95% confidence interval (CI), 0.67-1.00; P=0.04] and two years (RR=0.86; 95% CI, 0.78-0.95; P=0.003). However, no significant difference was detected at four years (RR=0.94; 95% CI, 0.85-1.04; P=0.24). Among patients with breast cancer, there was a significant survival benefit of psychosocial interventions at one year (RR=0.59; 95% CI, 0.42-0.82; P=0.002), but no difference at two years (RR=0.82; 95% CI, 0.67-1.02; P=0.07) or four years (RR=0.95; 95% CI, 0.73-1.23; P=0.68). Group-delivered interventions had a significant survival benefit favouring the intervention group at one year (RR=0.57; 95% CI, 0.41-0.79; P=0.0008), but no difference at two years (RR=0.84; 95% CI, 0.68-1.02; P=0.08) or four years (RR=0.94; 95% CI, 0.75-1.20; P=0.64). Individually-delivered interventions had no significant survival benefit at one year (RR=0.92; 95% CI, 0.791.08; P=0.32), two years (RR=0.87; 95% CI, 0.75-1.00; P=0.05), or four years (RR=0.93; 95% CI, 0.84-1.04; P=0.21).Conclusions: For the main analysis and group-delivered treatments, psychosocial interventions demonstrated only short-term improvements in survival. Individually-delivered interventions failed to show any survival benefit. Future studies with longer follow-up are warranted to investigate long-term survival outcomes.