AbstractThe effectiveness of psychological interventions (PI) for malignant diseases is controversial. We aimed to investigate the effect of PI on survival and quality of life (QoL) in patients with cancer. We performed a systematic search of MEDLINE, Cochrane, and Embase databases to identify randomized controlled trials comparing PI to standard care (PROSPERO registration number CRD42021282327).

摘要心理干预（PI）对恶性疾病的有效性存在争议。我们旨在调查PI对癌症患者生存和生活质量（QoL）的影响。我们对MEDLINE，Cochrane和Embase数据库进行了系统搜索，以确定将PI与标准护理（PROSPERO注册号CRD42021282327）进行比较的随机对照试验。

Outcomes were overall survival (OS), recurrence-free survival (RFS), and different domains of QoL. Subgroup analysis was performed based on the provider-, type-, environment-, duration of intervention; cancer stage, and type. Pooled hazard ratios (HR) and standardized mean difference (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model.

结果是总生存期（OS），无复发生存期（RFS）和生活质量的不同领域。根据提供者，类型，环境，干预持续时间进行亚组分析；癌症分期和类型。使用随机效应模型计算具有95%置信区间（CI）的汇总风险比（HR）和标准化平均差（SMD）。

The OS and RFS did not differ significantly between the two groups (OS:HR = 0.97; CI 0.87–1.08; RFS:HR = 0.99; CI 0.84–1.16). However, there was significant improvement in the intervention group in all the analyzed domains of QoL; in the global (SMD = 0.65; CI 0.35–0.94), emotional (SMD = 0.64; CI 0.33–0.95), social (SMD = 0.32; CI 0.13–0.51) and physical (SMD = 0.33; CI 0.05–0.60) domains.

OS和RFS在两组之间没有显着差异（OS:HR=0.97；CI 0.87-1.08；RFS：HR=0.99；CI 0.84-1.16）。然而，干预组在生活质量的所有分析领域都有显着改善；在全球（SMD=0.65；CI 0.35-0.94），情绪（SMD）=0.64；CI 0.33-0.95），社交（SMD）=0.32；CI 0.13-0.51）和物理（SMD=0.33；CI 0.05–0.60）域。

The effect of PI on QoL was generally positive immediately, 12 and 24 weeks after intervention, but the effect decreased over time and was no longer found significant at 48 weeks. The results were better in the breast cancer group and early stages of cancer. PIs do not prolong survival, but they significantly improve the QoL of cancer patients.

PI对生活质量的影响在干预后12周和24周通常是积极的，但随着时间的推移，效果下降，在48周时不再显着。乳腺癌组和癌症早期的结果更好。PI不会延长生存期，但会显着改善癌症患者的生活质量。

PI should be added as standard of care 3–4 times a year, at least for patients with early-stage cancer..

至少对于早期癌症患者，PI应每年增加3-4次作为标准护理。。

IntroductionCancer is a leading cause of death and reduces life expectancy worldwide1. GLOBOCAN estimated that there were 19.3 million new cancer cases, and almost 10 million led to death in 2020, irrespective of the world region2. In Europe, the most common causes of cancer-related deaths are lung (380,000 deaths, one-fifth of the total), colorectal (250,000 deaths, 12.6%), breast (140,000, 7.3%; females only) and pancreatic (130,000, 6.8%) cancers.

引言癌症是导致死亡的主要原因，并降低了全世界的预期寿命1。GLOBOCAN估计，2020年有1930万新发癌症病例，近1000万人死亡，与世界区域无关2。在欧洲，与癌症相关的死亡最常见的原因是肺癌（380000人死亡，占总数的五分之一），结直肠癌（250000人死亡，12.6%），乳腺癌（140000人，7.3%；仅女性）和胰腺癌（130000人，6.8%）癌症。

Altogether, these cancers account for 47% of all cancer-related mortality. The disease affects not only a large number of patients but also their families and the healthcare system, taking a psychological, physical, and financial toll3.Survival used to be almost the only goal of cancer treatment; however, quality of life (QoL) is increasingly recognized as an essential outcome criterion for oncological treatments and has been linked to survival prediction4.

总之，这些癌症占所有癌症相关死亡率的47%。这种疾病不仅影响大量患者，而且影响他们的家人和医疗保健系统，需要付出心理、身体和财务上的代价。过去，生存几乎是癌症治疗的唯一目标；然而，生活质量（QoL）越来越被认为是肿瘤治疗的重要结果标准，并且与生存预测有关4。

Receiving a cancer diagnosis unquestionably has a negative impact on the QoL, which is related to the prognosis of the disease itself, the choice of treatment, and the duration of the disease. The need for frequent hospitalizations, negative emotions, and several symptoms significantly reduce the QoL of these patients5.

接受癌症诊断无疑会对生活质量产生负面影响，这与疾病本身的预后，治疗的选择和疾病的持续时间有关。频繁住院，负面情绪和几种症状的需要显着降低了这些患者的生活质量5。

For these reasons, the need for psychosocial interventions to treat and support these patients, as well as cancer survivors, has increased recently6.The exact effect of how psychological interventions can improve QoL and prolong survival is inconclusive. Existing studies are based on small samples and are inconsistent regarding intervention provider, delivery methods, intervention type, duration and intensity, follow-up measurement periods, and methodological quality7,8,9,10.Targeting this gap in existing literature, we aimed to investigate the impact of .

由于这些原因，治疗和支持这些患者以及癌症幸存者的心理社会干预需求最近有所增加6。心理干预如何改善生活质量和延长生存期的确切效果尚无定论。现有研究基于小样本，在干预提供者，分娩方法，干预类型，持续时间和强度，随访测量期以及方法学质量方面不一致7,8,9,10。针对现有文献中的这一差距，我们旨在调查的影响。

Data availability

数据可用性

All data is shared as an additional file.

所有数据都作为附加文件共享。

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Download referencesFundingOpen access funding provided by Semmelweis University. Funding was provided by the New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund (to BT–ÚNKP-22-3-I-PTE-1693 and to KM–ÚNKP-22-4-II) and by an ITM NRDIF grant (TKP2021-EGA-23).

下载Semmelweis大学提供的参考基金开放获取资金。创新和技术部新的国家卓越计划从国家研究、发展和创新基金（BT-NKP-22-3-I-PTE-1693和KM-NKP-22-4-II）和ITM NRDIF赠款（TKP2021-EGA-23）的来源提供资金。

Sponsors had no role in the design, data collection, analysis, interpretation, and manuscript preparation.Author informationAuthor notesThese authors contributed equally: Katalin Márta and Péter HegyiAuthors and AffiliationsInstitute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, HungarySára Anna Bognár, Beatrix Fogarasi, Olga Júlia Zahariev, Bálint Erőss, Katalin Márta & Péter HegyiCentre for Translational Medicine, Semmelweis University, 1085, Budapest, HungarySára Anna Bognár, Brigitta Teutsch, Stefania Bunduc, Dániel Sándor Veres, Bence Szabó, Olga Júlia Zahariev, Omer Almog, Yael Hadani, Dorottya Gergő, Bálint Erőss, Stefania Bunduc, Katalin Márta & Péter HegyiInstitute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, HungaryBrigitta Teutsch, Nóra Vörhendi, Bálint Erőss & Péter HegyiDepartment of Biophysics and Radiation Biology, Semmelweis University, 1085, Budapest, HungaryDániel Sándor VeresDepartment of Internal Medicine, Siófok City Hospital and Outpatient Clinic, 8601, Siófok, HungaryNóra VörhendiDepartment of Pharmacognosy, Semmelweis University, Üllői út 26, 1085, Budapest, HungaryDorottya GergőDepartment of Internal Medicine and Hematology, Medical School, Semmelweis University, 1088, Budapest, HungaryEmese MihályCenter for Digestive Diseases and Liver Transplant, Fundeni Clinical Institute, 022328, Bucharest, RomaniaStefania BunducTranslational Pa.

赞助商在设计，数据收集，分析，解释和稿件准备中没有任何作用。作者信息作者注意到，这些作者做出了同样的贡献：塞梅尔维斯大学胰腺疾病研究所，1083年，布达佩斯，亨加拉·安娜·波格纳，比阿特丽克斯·福加拉西，奥尔加·朱利亚·扎哈里耶夫，巴林特·埃尔斯，塞梅尔维斯大学卡塔林·马尔塔和佩特·海基斯转化医学中心，1085年，布达佩斯，亨加拉·安娜·波格纳，布里吉塔·特奇，斯特凡尼亚·邦杜克，达尼尔桑多尔·维雷斯、本斯·萨博、奥尔加·朱利亚·扎哈里耶夫、奥马尔·阿尔莫格、亚尔·哈达尼、多洛蒂亚·格尔格、巴林特·埃尔斯、斯特凡尼亚·本杜克、卡塔林·马尔塔和佩特尔·赫吉伊转化医学研究所、佩奇大学医学院、7623、佩奇、亨加里·布里吉塔·特奇、诺拉·弗伦迪、巴林特·埃尔斯和佩特尔·赫吉德生物物理与辐射生物学系大学，1085，布达佩斯，HungaryDániel Sándor VeresDepartment of Internal Medicine，Siófok City Hospital and Outline Clinic，8601，Siófok，亨加雷诺拉·弗伦迪塞梅尔维斯大学生药学系，匈牙利首都布达佩斯，亨加雷多罗提亚·格尔格，塞梅尔维斯大学医学院内科和血液学系，布达佩斯，匈牙利医学院消化疾病和肝移植中心，芬德尼临床研究所，022328，布加勒斯特，罗曼尼亚斯特法尼亚联邦翻译宾夕法尼亚州。

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PubMed Google ScholarContributionsASB helped in conceptualization, project administration, and writing original drafts. BT and SB contributed to conceptualization, data curation, methodology, writing original drafts, review, and editing. DSV and BSz helped in conceptualization and formal analysis and review and editing.

PubMed Google ScholarContributionsASB帮助概念化，项目管理和撰写原始草案。BT和SB为概念化，数据管理，方法论，撰写原始草案，审查和编辑做出了贡献。DSV和BSz帮助概念化和正式分析以及审查和编辑。

BF, NV, OA, YH and DG helped in conceptualization and data curation. BE, EM, OJZ contributed to conceptualization and review, and editing. KM helped with the conceptualization, supervision, writing of the original draft, and review and editing. PH helped in conceptualization, funding acquisition, writing of the original draft– review, and editing.

BF，NV，OA，YH和DG有助于概念化和数据管理。BE，EM，OJZ为概念化，审查和编辑做出了贡献。KM帮助构思、监督、撰写原稿以及审查和编辑。PH帮助概念化，资金获取，撰写原稿-审查和编辑。

All authors provided critical conceptual input and approved the final version of the article.Corresponding authorCorrespondence to.

所有作者都提供了重要的概念输入，并批准了文章的最终版本。对应作者对应。

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Reprints and permissionsAbout this articleCite this articleBognár, S.A., Teutsch, B., Bunduc, S. et al. Psychological intervention improves quality of life in patients with early-stage cancer: a systematic review and meta-analysis of randomized clinical trials.

转载和许可本文引用本文Bognar，S.A.，Teutsch，B.，Bunduc，S。等人。心理干预改善早期癌症患者的生活质量：随机临床试验的系统评价和荟萃分析。

Sci Rep 14, 13233 (2024). https://doi.org/10.1038/s41598-024-63431-yDownload citationReceived: 03 October 2023Accepted: 29 May 2024Published: 09 June 2024DOI: https://doi.org/10.1038/s41598-024-63431-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsNeoplasmSurvivalQuality of lifePsychosocial intervention

关键词血浆生存质量心理社会干预

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