SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
Comparison of the Effects of Cognitive-Supportive-Relaxation Multimodal Psychosocial Intervention on Fear of Cancer Recurrence and Psychological Resilience in Breast Cancer Patients: A Network Meta-Analysis Based on Randomized Controlled Trials
Provisionally accepted
- 1Chengdu Fifth People's Hospital, Chengdu, China
- 2The Second Clinical Medical College of Yunnan University of Traditional Chinese Medicine, kunming, China
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Background Fear of cancer recurrence (FCR) is common and clinically significant in breast cancer patients, impairing physical and psychological well-being. Psychotherapies show heterogeneous effects on FCR and resilience, but few network meta-analyses have compared their relative efficacy. This study systematically evaluated the effectiveness of mind-body interventions for mitigating FCR and enhancing resilience in breast cancer patients. Methods Randomized controlled trials (RCTs) of psychotherapies for FCR, anxiety, and depression in breast cancer patients were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, Wanfang, and CBM from January 2019 to March 2025. Two reviewers screened studies, extracted data, and assessed methodological quality. Network meta-analysis was performed using RevMan 5.4 and Stata 17.0. Results Nineteen RCTs involving 11 interventions and 2214 participants were included. Couple skills training showed probabilistic advantages for FCR (Fear of Cancer Recurrence Inventory); narrative therapy was effective for recurrence-related concerns; CBT had probabilistic benefits for fear of progression (Fear of Progression Questionnaire-Short Form) and positive psychological capital (Positive Psychological Capital Questionnaire); and both CBT and mindfulness outperformed other interventions for anxiety and depression (Hospital Anxiety and Depression Scale). Sensitivity and subgroup analyses confirmed robustness, with measurement time points and treatment status as major sources of heterogeneity (I²=91.9%, P<0.001). Conclusion Different psychotherapies show outcome-specific benefits, supporting personalized approaches for FCR, distress, and resilience. Limitations include heterogeneous protocols, variable measures, and limited trials for some interventions. Future high-quality RCTs with standardized protocols and long-term follow-up are needed.
Keywords: breast cancer, cognitive behavioral therapy, Fear of cancer recurrence, Network meta-analysis, psychological resilience
Received: 21 Mar 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Yuan, Li, Li, Dai, Deng and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: lang He
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