# Effects of psychosocial interventions on cancer-related fatigue in patients with colorectal cancer: a systematic review and meta-analysis of randomised controlled trials

## TL;DR

Psychosocial interventions, especially psycho-behavioural approaches, can reduce cancer-related fatigue in colorectal cancer patients, but more research is needed.

## Contribution

This study provides a systematic review and meta-analysis of psychosocial interventions for cancer-related fatigue in colorectal cancer patients.

## Key findings

- Psychosocial interventions significantly reduced cancer-related fatigue at short-, medium-, and long-term follow-ups.
- Psycho-behavioural interventions were effective, while psychotherapy and yoga showed no significant effects.
- The certainty of evidence ranged from very low to moderate, indicating a need for more rigorous trials.

## Abstract

This review aimed to scrutinise and critically appraise the evidence on the effects of psychosocial interventions in alleviating CRF for colorectal cancer patients.

MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Ultimate, APA PsycInfo, CNKI, and WANFANG Database were electronically searched from inception to 31st August 2025 for randomised controlled trials examining psychosocial interventions for CRF in colorectal cancer patients. Meta-analyses were performed for short-term (immediately post-intervention to 1 month), medium-term (> 1 to 3 months), and long-term (> 3 months) follow-up periods. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The Review Manager Software (Version 5.4.1) was used for data analysis.

Nine studies with 1426 participants were included. Interventions were categorised as psychotherapies, psycho-behavioural interventions, and yoga. Meta-analyses indicated that compared to controls, psychosocial interventions significantly reduced CRF at short-term (standardised mean difference (SMD) = −0.53, 95% confidence interval (CI) = −0.82 to −0.23), medium-term (SMD = −0.51, 95%CI = −0.73 to −0.29), and long-term (SMD = −0.24, 95%CI = −0.46 to −0.01) follow-up. Subgroup analyses indicated that psycho-behavioural interventions were effective (SMD = −0.39, 95% CI = −0.76 to −0.01), while psychotherapy and yoga showed no significant effects. The certainty of evidence ranged from very low to moderate.

Psychosocial interventions, particularly psycho-behavioural approaches, appear effective in reducing CRF among patients with colorectal cancer; however, effects were consistent at medium-term and long-term follow-up, while short-term findings showed substantial heterogeneity. More rigorous, adequately powered trials are needed to strengthen and extend the current evidence base.

The online version contains supplementary material available at 10.1007/s00520-026-10565-6.