Effectiveness of Supportive-Expressive Group Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis.

ABSTRACT

INTRODUCTION: Breast cancer is the most frequently diagnosed cancer among women and ranks second in terms of global incidence. Depression, anxiety, and poor quality of life (QoL) are prevalent in women with breast cancer. Supportive-expressive group therapy (SEGT) can potentially benefit these patients. OBJECTIVE: This systematic review and meta-analysis evaluated the effectiveness of SEGT for women with breast cancer, by focusing on survival, QoL, anxiety, and depression as outcomes. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. The databases PubMed, Web of Science, Cochrane Library, Embase, CINHAL, and PsycInfo in English, and Sinomed, CNKI, CQVIP, and Wanfang in Chinese, were searched from inception up to May 2020 for relevant full-text articles using "SEGT," "breast cancer," and related terms as keywords. Randomized controlled trials (RCTs) comparing SEGT with baseline conditions of patients with breast cancer were included in the analysis. RESULTS: Ten studies with a total of 2,879 subjects were analyzed. Overall group differences were found for survival (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.72-0.94; p = 0.004), short-term QoL (mean difference [MD] 8.02, 95% CI 4.85-11.20; p < 0.00001), long-term QoL (MD 11.30, 95% CI 6.75-15.84; p < 0.00001), Profile of Mood States score (POMS) score (MD -0.43, 95% CI -0.72 to -0.13; p = 0.005), anxiety (standardized MD [SMD] -0.30, 95% CI -0.49 to -0.10; p = 0.003), and depression (SMD -0.47, 95% CI -0.66 to -0.29; p < 0.00001). CONCLUSIONS: SEGT is effective in improving QoL and psychosocial status in breast cancer patients, but there is no convincing evidence that it has an impact on survival.