Abstract
BACKGROUND: Substantial clinical evidence supports the efficacy of cognitive behavioral therapy (CBT) for various diseases, particularly in oncology. However, the true impact of CBT interventions on cancer-related fatigue and mental health in patients with ovarian cancer remains unknown. AIM: To evaluate the effects of CBT on fatigue, anxiety, depression and quality of life in patients with ovarian cancer. METHODS: Randomized controlled trials (RCTs) on CBT for patients with ovarian cancer were searched in the PubMed, EMBASE, Web of Science and Cochrane Library databases. According to the preferred reporting items for systematic reviews and meta-analyses statement, we formulated the inclusion and exclusion criteria, strictly screened the literatures, extracted data and performed a meta-analysis. RESULTS: Six RCTs with 332 ovarian cancer patients were included. Compared with the control group, cancer fatigue [mean difference (MD) = -0.98, 95% confidence interval (CI): -1.47 to -0.50], anxiety [standardized mean difference (SMD) = -0.64, 95%CI: -0.91 to -0.36] and depression levels (SMD = -0.41, 95%CI: -0.76 to -0.06) of the patients in the experimental group reduced after CBT intervention. Quality of life (MD = 1.28, 95%CI: 0.65 to 1.90) and sleep quality (MD = -0.49, 95%CI: -0.66 to -0.33) of the patients improved, and the differences between the groups were statistically significant (P < 0.01). The quality evaluation results suggested that the quality of the included RCTs was low. The meta-regression results showed that patient age and nurse guidance affected treatment outcomes, especially anxiety, whereas the specific method of CBT had a non-significant effect. CONCLUSION: CBT effectively improves mental status and cancer-related fatigue in patients with ovarian cancer undergoing chemotherapy. Future research should prioritize adequately powered RCTs with standardized outcome measures and longitudinal designs to establish sustained efficacy.