Table 2.
Characteristics of the included studies
| Sample size | Mean age | Gender distribution [N (%) female] | Race/ Ethnicity [N (%)] | Intervention | Outcome assessment | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Author, year | Sample | Fatigue eligibility criterion | MBI | Control(s) | MBI | Control(s) | MBI | Control(s) | MBI | Control(s) | Origin | MBI | Control(s) | Follow-up time point(s) | Fatigue outcome (Measure) |
| Blaes, 2016 | Any cancer type (69.0% breast), stage I-III, ≤6 mos. post-curative tx | NA | 28 | 14 | 55 | 57 | 26 (92.9%) | 12 (85.7%) | NR | NR | United States | MBCR; 8 weekly 2.5-hour sessions + 8-hour retreat | Waitlist | Post-interv. 2 mos. post-interv. | Fatigue (FACT-F)b |
| Bower, 2015 | Breast cancer, stage 0-III dx at age ≤50, ≥3 mos. to ≤10 years post-tx (excl. hormone therapy) | NA | 39 | 32 | 46.1 | 47.7 | 39 (100.0%) | 32 (100.0%) | White: 29 (74.4%) Black: 1 (2.6%) Asian: 3 (7.7%) Other: 6 (15.4%) | White: 25 (78.1%) Black: 1 (3.1%) Asian: 5 (15.6%) Other: 1 (3.1%) | United States | MAPs; 6 weekly 2-hour sessions | Waitlist | Post-interv. 3 mos. post-interv. | Fatigue (FSI) |
| Bruggeman-Everts, 2017 | Any cancer type (47.3% breast), ≥3 mos. post-curative tx (excl. hormone therapy) | ≥35 CIS-FS | 55 | 62 (AAF); 50 (PE) | 51.36 | 56.45 (AAF); 56.54 (PE) | 39 (70.9%) | 44 (80.0%; AAF); 40 (80.0%; PE) | NR | NR | The Netherlands | Web-based eMBCT; 4 hours/week for 9 weeks | Home-based AAF; 3 hours/week for 9 weeks PE emails; 10 min./week for 9 weeks | Post-interv. 4 mos. post-interv. | Fatigue severity (CIS-FS)a,b |
| Carlson, 2016 | Breast cancer, stage 0-IV, ≥3 mos. post-tx (excl. hormone therapy), score ≥4 Distress Thermometer | NA | 134 | 118 | 55.12 | 54.14 | 134 (100.0%) | 118 (100.0%) | NR | NR | Canada | MBCR; 8 weekly 1.5-hour sessions + 6-hour retreat | SET; 12 weekly 1.5-hour sessions SMS;** 1-day minimal attention waitlist | Post-interv. 6 mos. post-interv. 12 mos. post-interv. | Fatigue (POMS)b Vigor (POMS)b |
| Cheng, 2019 | Any cancer type (65.4% breast), stage I-III, ≥1 mo. post-curative tx | NA | 25 | 27 | 54.04b | 53.74b | 23 (92.0%) | 24 (88.9%) | NR | NR | Taiwan | Unspecified Mindfulness interv. 12 weekly 2-hour sessions | Qigong; 12 weekly 2-hour sessions | Post-interv. 3 mos. post-interv. | Cancer Related Fatigue (CRF scale) |
| Dodds, 2015 | Breast cancer, stage I-IV, ≤10 years post-adj. systemic chemo | NA | 12* | 16* | 54.7 | 55.8 | 12 (100.0%) | 16 (100.0%) | White: 11 (91.7%) Other: 1 (8.3%) | White: 12 (75.0%) Other: 4 (25.0%) | United States | CBCT; 8 weekly 2-hour sessions + booster 1 mo. post-interv. | Waitlist | Post-interv. 1 mo. post-interv. | Vitality (SF-12) |
| Hoffman, 2012 | Breast cancer, stage 0-III, ≥2 mos. to ≤2 years post-tx (excl. hormone therapy) | NA | 103* | 111* | 49.0 | 50.1 | 103 (100.0%) | 111 (100.0%) | NR | NR | United Kingdom | Original MBSR; 8 weekly 2-hour sessions (session 1 and 8 were 2.25 hours) + 6-hour retreat | Waitlist | Post-interv. 1 mo. post-interv. | Fatigue (POMS) Vigor (POMS) |
| Jang, 2016 | Breast cancer, stage 0-III, <2 years post-curative tx | NA | 12 | 12 | 51.75 | 51.42 | 12 (100.0%) | 12 (100.0%) | NR | NR | South Korea | Adapted MBAT; 12 weekly 45-minute sessions | Waitlist | Post-interv. | Fatigue (QLQ-C30) |
| Johns, 2015 | Any cancer type (86% breast), stage I-IV, ≥3 mos. post-tx (excl. hormone therapy) | ≥4 FSI-SC | 18 | 17 | 58.8 | 55.7 | 17 (94.4%) | 16 (94.1%) | White: 15 (83.3%) Other: 3 (16.7%) | White: 13 (76.5%) Other: 4 (23.5%) | United States | Adapted MBSR; 7 weekly 2-hour sessions | Waitlist | Post-interv. 1 mo. post-interv. | Fatigue (FSI)a,b Vitality (SF-36)b |
| Johns, 2016 | Breast or colorectal cancer (85% breast), stage 0-III, ≥3 mos. to ≤5 years post-tx (excl. hormone therapy) | ≥4 FSI-SC | 35 | 36 | 56.9 | 56.4 | 33 (94.3%) | 31 (86.1%) | White: 27 (77.1%) Other: 8 (22.9%) | White: 23 (63.9%) Other: 13 (36.1%) | United States | Adapted MBSR; 8 weekly 2-hour sessions | PES; 8 weekly 2-hour sessions | Post-interv. 6 mos. post-interv. | Fatigue (FSI)a Vitality (SF-36) |
| Kenne Sarenmalm, 2017 | Breast cancer, post-adj. chemo and/or radiation | NA | 62 | 52 (S-MBSR); 52 (UC) | 57.2 | 57.2 (S-MBSR); 57.2 (UC) | 62 (100.0%) | 52 (100.0%; S-MBSR); 52 (100.0%; UC) | NR | NR | Sweden | Adapted MBSR; 8 weekly 2-hour sessions | Self-guided MBSR; 2 hours/week for 8 weeks UC | Post-interv. | Vitality (SF-36) |
| Lengacher, 2009 | Breast cancer, stage 0-III, ≤18 mos. post-curative tx (surgery + adj. radiation or chemo) | NA | 40* | 42* | 57.1 | 58.0 | 40 (100.0%) | 42 (100.0%) | White: 36 (87.8%) Black: 2 (4.9%) Hispanic: 6 (14.6%) Other: 3 (7.3%) | White: 34 (79.1%) Black: 8 (18.6%) Hispanic: 3 (7.0%) Other: 1 (2.3%) | United States | Adapted MBSR(BC); 6 weekly 2-hour sessions | Waitlist | Post-interv. | Vitality (SF-36)b |
| Lengacher, 2012 | Breast cancer, stage 0-III, ≤18 mos. post-curative tx (surgery + adj. radiation or chemo) | NA | 40* | 42* | 57.1 | 58.0 | 40 (100.0%) | 42 (100.0%) | White: 36 (87.8%) Black: 2 (4.9%) Hispanic: 6 (14.6%) Other: 3 (7.3%) | White: 34 (79.1%) Black: 8 (18.6%) Hispanic: 3 (7.0%) Other: 1 (2.3%) | United States | Adapted MBSR(BC); 6 weekly 2-hour sessions | Waitlist | Post-interv. | Fatigue symptom cluster (MDASI) |
| Lengacher, 2016 | Breast cancer, stage 0-III, ≥2 weeks to ≤2 years post-tx | NA | 167 | 155 | 56.5 | 57.6 | 167 (100.0%) | 155 (100.0%) | White: 112 (67.1%) Black: 21 (12.6%) Hispanic: 19 (11.4%) Other: 15 (9.0%) NR: 0 (0.0%) | White: 110 (71.0%) Black: 16 (10.3%) Hispanic: 14 (9.0%) Other: 13 (8.4%) NR: 2 (1.3%) | United States | Adapted MBSR(BC); 6 weekly 2-hour sessions | Waitlist | Post-interv. 1.5 mos. post-interv. | Fatigue (FSI) |
| Liu, 2019 | Differentiated thyroid cancer (DTC), stage I-IV (excl. metastasis to other organ), first upcoming radioactive iodine tx scheduled | NA | 49* | 53* | 43.32 | 42.38 | 34 (69.4%) | 38 (71.7%) | NR | NR | China | Adapted MBSR; 8 weekly 2.5-hour sessions | UC | Post-interv. 3 mos. post-interv. | Fatigue (QLQ-C30) |
| Monti, 2006 | Any female cancer type (46% breast), stage 0-IV, ≥4 mos. to ≤2 years post-dx | NA | 56 | 55 | 53.1 | 54.1 | 56 (100.0%) | 55 (100.0%) | White: 45 (80.4%) Black: 10 (17.9%) Asian: 1 (1.8%) Hispanic: 0 (0.0%) Other: 0 (0.0%) | White: 38 (69.1%) Black: 13 (23.6%) Asian: 1 (1.8%) Hispanic: 2 (3.6%) Other: 1 (1.8%) | United States | Original MBAT; 8 weekly 2.5-hour sessions | Waitlist | Post-interv. | Vitality (SF-36)b |
| Monti, 2013 | Breast cancer, stage 0-IV, ≥6 mos. to ≤3 years post-dx or post-recurrence | NA | 98 | 93 | 56.9 | 56.4 | 98 (100.0%) | 93 (100.0%) | White: 59 (60.2%) Black: 35 (35.7%) Other: 4 (4.1%) | White: 54 (58.1%) Black: 37 (38.8%) Other: 2 (2.2%) | United States | Original MBAT; 8 weekly 2.5-hour sessions | BCSG; 8 weekly 2.5-hour sessions | Post-interv. 6 mos. post-interv. | Vitality (SF-36)b |
| Rahmani, 2014 | Breast cancer, stage I-III, ≥1 mo. post-dx | NA | 12 | 12 (MCT); 12 (UC) | 43.25 | 44.92 (MCT); 44.08 (UC) | 12 (100.0%) | 12 (100.0%; MCT); 12 (100.0%; UC) | NR | NR | Iran | Adapted MBSR; 8 weekly 2-hour sessions | MCT; 8 weekly sessions UC | Post-interv. 2 mos. post-interv. | Fatigue (QLQ-C30) |
| Rahmani, 2015 | Breast cancer, stage I-III, ≥1 mo. post-dx | >4 FSS-P | 12 | 12 | 43.25 | 44.08 | 12 (100.0%) | 12 (100.0%) | NR | NR | Iran | Adapted MBSR; 8 weekly 2-hour sessions | UC | Post-interv. 2 mos. post-interv. | Fatigue severity (FSS-P)a |
| Speca, 2000 | Any cancer type (43% breast), stage I-IV | NA | 53* | 37* | 54.9 | 48.9 | 46 (86.8%) | 27 (73.0%) | NR | NR | Canada | Adapted MBSR; 7 weekly 1.5-hour sessions | Waitlist | Post-interv. | Fatigue (POMS) Vigor (POMS) |
| van der Lee, 2012 | Any cancer type (60% breast), ≥1 year post-curative tx | ≥35 CIS-FS | 59* | 24* | 53.1 | 49.4 | 51 (86.4%) | 19 (79.2%) | NR | NR | The Netherlands | Adapted MBCT; 8 weekly 2.5-hour sessions + 6-hour retreat + 2.5-hour booster 2 mos. post-interv. | Waitlist | Post-interv. 6 mos. post-interv. | Fatigue severity (CIS-FS)a |
| Witek-Janusek, 2019 | Breast cancer, stage 0-III, post-surgery | NA | 84* | 80* | 55 | 55.2 | 84 (100.0%) | 80 (100.0%) | White: 68 (81.0%) Black: 10 (11.9%) Asian: 1 (1.2%) Hispanic: 2 (2.4%) Other: 1 (1.2%) NR: 2 (2.4%) | White: 58 (72.5%) Black: 13 (16.3%) Asian: 1 (1.3%) Hispanic: 5 (6.3%) Other: 2 (2.5%) NR: 1 (1.3%) | United States | Original MBSR; 8 weekly 2.5-hour sessions + 6-hour retreat (after week 5) | ACC 8 weekly 2.5-hour sessions of education | Interv. midpoint Post-interv. 1 mo. post-interv. 6 mos. post-interv. | Fatigue (MFSI-SF) |
| Zernicke, 2014 | Any cancer type (33.9% breast), ≤3 years post-tx | NA | 30 | 32 | 58 | 58 | 22 (73.3%) | 23 (71.9%) | NR | NR | Canada | Online MBCR 8 weekly 2-hour sessions + 6-hour retreat (after week 6) | Waitlist | Post-interv. | Fatigue (POMS)b Vigor (POMS)b |
Note: AAF: Ambulant Activity Feedback; ACC: Active Control Condition; adj.: adjuvant; BC: breast cancer; BCSG: Breast Cancer Support Group; BL: baseline; CBCT: Cognitively-Based Compassion Training; chemo: chemotherapy; CIS-FS: Checklist Individual Strength-Fatigue Severity subscale; CRF scale: Cancer Related Fatigue scale; dx: diagnosis; eMBCT: web-based MBCT; excl.: excluding; FACT-F: Functional Assessment in Cancer Therapy-Fatigue; FSI: Fatigue Symptom Inventory; FSI-SC: Fatigue Symptom Inventory-Severity Composite; FSS-P: Fatigue Severity Scale - Persian; interv.: intervention; MAPs: Mindful Awareness Practices; MBAT: Mindfulness-Based Art Therapy; MBCR: Mindfulness-Based Cancer Recovery; MBCT: Mindfulness-Based Cognitive Therapy; MBI: mindfulness-based intervention; MBSR: Mindfulness-Based Stress Reduction; MCT: Metacognitive Therapy; MDASI: MD Anderson Symptom Inventory; MFSI-SF: Multidimensional Fatigue Scale Inventory-Short Form; min.: minutes; mo.: month; NA: not applicable; NR: not reported; PE: Psycho-educational; PES: Psycho-Educational Support; POMS: Profile of Mood States; QLQ-C30: Quality of Life Questionnaire-Core 30; SET: Supportive Expressive Therapy; SF-12: Medical Outcome Study-Short Form 12-Item Health Survey; SF-36: Medical Outcomes Study-Short Form 36-Item General Health Survey; SMS: Stress Management Seminar; tx: treatment; UC: Usual Care.
*
Number analyzed in outcome sample; full randomized sample N differs slightly.
**
SMS outcomes not assessed; all participants offered re-randomization to MBCR or SET after 12-week waitlist period.
a
Primary outcome(s) of the respective study.
b
Some of the data were not reported in study publications but were provided by the authors upon request.