Symptom management in adult brain tumours: A literature review.
Rong Zhang, Dong-Mei Wang, Yong-Li Liu and 4 others
PMID 37120840WHAT IT FOUND
Evidence for nonpharmacological symptom management in adult brain tumours is largely borrowed from other cancers, with insufficient data for fatigue, sleep, and distress.
Cognitive rehabilitation has some support. Routine assessment of these often-overlooked symptoms is recommended.
Key findings
01There are no randomized controlled trials of exercise for fatigue in adults with brain tumours, and evidence for nonpharmacological fatigue interventions is insufficient.
02Interventions for sleep disturbances, such as CBT-I and mindfulness, can currently only be used as alternative therapies for brain tumour patients due to a lack of specific evidence.
03A structured cognitive rehabilitation programme is the only new insight for nonpharmacological intervention in cognitive deficits, though evidence for exercise in this area is also limited.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The review did not exhaustively compare the advantages and disadvantages of different assessment tools. Pharmacological interventions were not reviewed. The timing of interventions was not linked to the staging of metastatic brain tumours. Much of the evidence for interventions is extrapolated from patients with other types of solid tumours, not specifically brain tumours. Biological mechanisms of symptom clusters in brain tumours are poorly understood compared to other cancers.
Declared interests
The work was supported by the Natural Science Foundation of Hubei Province in China. The authors declared no financial conflicts of interest.
The easy way to misread this
Do not assume that interventions proven effective in other cancer populations, such as exercise for fatigue or CBT-I for sleep, are equally effective or safe for patients with brain tumours. The review explicitly states that evidence for these interventions in brain tumour patients is insufficient or lacking.