Psychological and psychosocial interventions in patients with lung cancer: A meta-analysis of randomised controlled trials and trial sequential analysis
In brief
Psychosocial programs moderately ease anxiety and depression in lung cancer trials
Across 46 randomized trials involving 5,309 adults with lung cancer, psychological and psychosocial interventions moderately reduced anxiety and depression, with benefits also reported for stress, symptoms, sleep, quality of life and functioning. Results varied across studies, signs of small-study effects weakened some estimates, and the evidence base did not reach the planned information size, so larger trials are still needed to clarify who benefits and how best to deliver support.
- Journal
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Q1)
- Published
- 21 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Nur Aini, Fitria Endah Janitra, Chiao-Ling Lin, Nelsensius Klau Fauk, Ferry Efendi, Hidayat Arifin
- PMID
- 42777643
- DOI
- 10.1016/j.ejso.2026.112165
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (top studies of the week, 27 September 2026): Meta‑analysis of psychosocial interventions in lung cancer patients
Abstract
Lung cancer carries a heavy psychological burden, yet whether psychological and psychosocial interventions meaningfully improve outcomes in this population, and whether the accumulated evidence is sufficient, remains unconfirmed. We searched seven databases from inception to August 2025 for randomised controlled trials, pooled effects using random-effects meta-analysis with robust variance estimation for dependent effect sizes, appraised bias with Cochrane RoB 2.0, explored heterogeneity through moderator analyses, and applied trial sequential analysis (TSA). Across 46 trials (5309 participants), interventions reduced anxiety (Hedges' g = -0.53), depression (g = -0.42), stress (g = -0.44), fatigue (g = -0.52), pain (g = -0.39), self-perceived burden (g = -1.33) and sleep problems (g = -1.28), and improved dyspnoea (g = 0.40), quality of life (g = 0.39), well-being (g = 0.39), coping (g = 0.45), self-efficacy (g = 0.47), self-management efficacy (g = 0.82), pulmonary function (g = 0.69) and physical functioning (g = 0.51), with several gains sustained at follow-up. Moderator analyses favoured more frequent delivery and shorter sessions (≤60 min). Heterogeneity was substantial for several outcomes, and small-study effects were detected for anxiety, depression, stress and quality of life; trim-and-fill attenuated but did not abolish these effects (adjusted g = -0.33 and -0.32 for anxiety and depression). TSA showed that the cumulative Z-curve crossed the conventional significance boundary for every outcome tested, but the required information size was not reached. Psychological and psychosocial interventions are therefore associated with benefits across psychological, symptom, sleep, behavioural and functional domains in adults with lung cancer; evidence is most consistent for anxiety, depression, stress and quality of life. Adequately powered trials remain necessary, alongside optimisation of intervention dose, timing, delivery mode and patient targeting.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.