Efficacy of virtual reality-based interventions for patients with breast cancer symptom and rehabilitation management: a systematic review and meta-analysis

Objectives To determine the effectiveness of virtual reality (VR)-based intervention on the symptoms and rehabilitation management in patients with breast cancer. Design Systematic review and meta-analysis. Study selection We included all eligible randomised controlled trials and quasi-experimental studies (published in English and Chinese). Participants Patients with breast cancer (>= 18 years) undergoing cancer treatment. Interventions Any intervention administered to improve the symptoms and rehabilitation of patients with breast cancer. The control group was given conventional care. Outcomes All outcomes were as follows: pain, fatigue, anxiety, depressive symptoms, cognitive function, and range of motion of upper limb in patients with breast cancer. Data sources We searched PubMed, Embase, CENTRAL and SinoMed, four electronic databases, covering the database establishment period to January 2022. Review methods Two reviewers independently extracted content and data consistent with the prespecified framework and assessed risk bias. Random-effects meta-analysis was used to pool data across trials. Meta-analysis was performed using Review Manager V.5.4. Results A total of eight studies met the eligibility criteria and were included in this study. The combined effect size showed that VR was positive for improving patients' anxiety(standard mean differenc (SMD)=-2.07, 95% CI= (-3.81 to -0.34), I-2=95%) and abduction of upper limbs (MD=15.54, 95% CI= (12.79 to 18.29), I-2=0%), but fatigue (SMD=-0.92, 95% CI= (-4.47 to 2.62), I-2=99%) was not. Qualitative analysis showed VR improved patients' depressive symptoms, pain and cognitive function. Conclusions VR technology has a good effect on symptoms and rehabilitation management of patients with breast cancer, but the quality of evidence is low, and the sample size is small. To date, there are few intervention studies, therefore, giving precise recommendation or conclusion is difficult. We have a favourable view of this, and more clinical studies are needed in the future to improve the credibility of the results.