Comparison of Single Versus Multiple Nonpharmacological Interventions for the Management of Lung Cancer–Related Fatigue: A Systematic Review

ABSTRACT Background Lung cancer is one of the common cancers globally. One of the adverse symptoms of lung cancer and its treatment is fatigue. Pharmacological interventions have not shown efficacy on cancer‐related fatigue, and investigations on nonpharmacological interventions may be useful. This systematic review aims to evaluate the efficacy of nonpharmacological interventions on managing fatigue and quality of life outcomes among people undergoing treatment for lung cancer and evaluate if treatment efficacy differed between single and multimodal interventions. Methods Relevant literature published in MEDLINE, Scopus, Cochrane Library, CINAHL, and ProQuest from January 2003 to January 2023 was included. Included studies must have: participants over 16 years of age receiving treatment such as chemotherapy, radiotherapy, and/or surgery, cancer‐related fatigue (CRF) as an outcome, and must be randomized controlled trials. Two reviewers independently extracted data from eligible articles, and data analysis was performed using R 4.1.0 software. Results Total of 14 randomized controlled trials were included and categorized into four groups: physical activities, traditional Chinese medicine (TCM), education, and dietary counselling. Our extensive search did not find any multimodal studies related to CRF in patients with lung cancer. Pooled results of this systematic review found that TCM and education interventions have a significant positive impact on fatigue in patients with lung cancer. Physical activity and dietary counselling were not effective in managing fatigue. None of the reported nonpharmacological interventions in this review significantly impact QoL. Conclusions This review identified that TCM and educational programs improved CRF in patients with lung cancer. However, physical activities and dietary counselling did not show any improvements in fatigue for patients undergoing lung cancer treatment. Registration PROSPERO registration ID: CRD42023407326.