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Supportive Care in Cancer

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01-04-2020 | Acupuncture | Original Article

The efficacy of placebo for the treatment of cancer-related fatigue: a systematic review and meta-analysis

Authors: Pedro Nazareth Aguiar Junior, Carmelia Maria Noia Barreto, Daniel de Iracema Gomes Cubero, Auro del Giglio

Published in: Supportive Care in Cancer | Issue 4/2020

Abstract

Purpose

Cancer-related fatigue (CRF) is a common symptom among patients with cancer. The efficacy of placebo, however, was never the main objective of any meta-analysis. Predicting the efficacy of placebo may facilitate researchers in designing future clinical trials for the treatment of CRF.

Methods

We performed a systematic review searching for prospective clinical trials comparing any treatment versus placebo for the treatment of CRF. We included studies that enrolled patients with any primary site of neoplasia and any stage of cancer. We excluded all studies that assessed fatigue related to any treatment. The primary endpoint of this study is the mean effect of placebo on fatigue according to the Functional Assessment of Chronic Illness (FACIT-F) and Brief Fatigue Inventory (BFI) scales. The secondary endpoint was the proportion of patients who reported improvement in fatigue (response rate).

Results

We found 520 studies, and 29 studies with 3758 participants were included in the meta-analysis. Placebo had a mean effect of + 4.88 (95%CI + 2.45 to + 7.29) using the FACIT-F scale, although it was statistically worse than the interventions studied (p = 0.005). Using the BFI scale, placebo had an average effect of + 0.64 (95%CI + 0.02 to + 1.30), although it was also worse than the other interventions studied (p = 0.002). In terms of the response rate, 29% (95%CI 25–32%) of patients taking a placebo reported a significant improvement in CRF compared with 36% of patients treated with other interventions (p = 0.030).

Conclusions

Placebo treatments had a significant effect on CRF, and predicting these effects may help design future studies for CRF.

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Title: The efficacy of placebo for the treatment of cancer-related fatigue: a systematic review and meta-analysis
Authors: Pedro Nazareth Aguiar Junior
Carmelia Maria Noia Barreto
Daniel de Iracema Gomes Cubero
Auro del Giglio
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acupuncture
Care
Cancer Fatigue
Fatigue
Published in: Supportive Care in Cancer / Issue 4/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-04977-w

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