What are the optimal mind-body therapies for cancer-related pain? A network meta-analysis

Abstract Introduction Current international guidelines encourage cancer patients to engage in physical activity and recommend mind-body therapies (MBTs) as a method for treating cancer-related pain (CRP). However, the most effective MBTs for improving CRP in this population remain unknown. Therefore, this network meta-analysis (NMA) aimed to assess and rank the relative efficacy of different MBTs for CRP, and to conduct subgroup analyses according to different cancer types and stages of treatment. Content Eight electronic databases were searched for randomized controlled trials (RCTs) that compared different MBTs to improve pain in adults living with cancer. RCTs were evaluated using the Cochrane risk of bias tool. A random effects network meta-analysis was performed within a frequentist framework. Of the 4,916 articles retrieved and screened against the selection criteria. 36 studies with a total 2,387 participants were eligible to be included in the analysis. Qigong demonstrated significantly greater effects than Usual care (standardized mean difference [SMD] −0.85, 95 % confidence interval [CI] −1.46 to −0.24), Waitlist (SMD −0.93, −1.77 to −0.08), and Massage (SMD −1.71, −3.20 to −0.23), with the highest surface under the cumulative ranking value of 86.5 %, was ranked first. It was preceded by Conventional exercise (75.2 %), Taichi (74.9 %), with Massage having the lowest rank (7.2 %). In a subgroup analysis of breast cancer, Taichi (89.6 %), Conventional exercise (68.4 %), and Pilates (68.3 %) ranked as the top three. Summary and outlook This network meta-analysis indicates that Qigong and Tai Chi are among the most effective mind–body therapies (MBTs) for managing cancer-related pain and may serve as complementary adjuvant treatments for patients with cancer.