Abstract
BACKGROUND: Cancer-related cognitive impairment (CRCI) associated with chemotherapy ('chemobrain') in patiens with breast cancer represents a challenging sequelae of cancer treatment. Cognitive training (CT) has shown potential to improve CRCI. AIM: This systematic review with meta-analysis aimed to evaluate the efficacy of CT in improving CRCI in patients with breast cancer. METHODS: A systematic literature review was conducted in PubMed, Web of Science, Scopus, Embase, Cochrane Library, PsycInfo, CINAHL Complete, ClinicalTrials.gov and Psicodoc databases for studies published up to January 2025. Methodological quality was assessed using PRISMA, RoB 2 and the PEDro Scale. The protocol was registered in PROSPERO (CRD42025636745). RESULTS: Of 7751 studies identified, 11 met inclusion criteria and 9 were included in the meta-analysis. Eight studies assessed the effect of CT on the FACT-Cog scale global score, showing a significant effect (SMD = 0.2; IC del 95%: -0.39 a -0.01; p = 0.04), and low heterogeneity (I(2) = 0%). Seven studies analysed perceived cognitive impairments (PCI), perceived cognitive abilities (PCA), and impact on quality of life (QOL), while six included comments from others (OTH), showing a significant overall effect (SMD = 0.39; IC del 95%: -0.58 a -0.19; p < 0.001), with no significant heterogeneity. There were significant improvements in PCI and PCA. Funnel plots analysis suggested possible publication bias. CONCLUSIONS: CT could be effective in improving CRCI in patients with breast cancer. However, the existing evidence is of low quality and, therefore, higher quality studies with larger samples are still warranted.