Effectiveness of Mindfulness-Based Interventions on Breathlessness in Lung Cancer: A Meta-Analysis.

Abstract

Breathlessness is the most common and distressing symptom in lung cancer, but no systematic review has examined the effectiveness of mindfulness-based interventions on breathlessness. To evaluate the effectiveness of mindfulness-based interventions on breathlessness, pulmonary function, and psychological well-being in lung cancer. According to the PRISMA guidelines, we conducted a systematic search across ten databases from inception to February 2025. Only randomized controlled trials were included. Fourteen RCTs from 15 papers (N = 1190) were included. Pooled results: compared with a control, mindfulness-based interventions did not show a significant improvement in breathlessness [SMD = -0.44, 95% CI: -0.92 to 0.05, n = 5]; indicated a significant improvement in pulmonary function including vital capacity [MD = 0.44 L, 95% CI: 0.18-0.70, n = 2], peak expiratory flow [MD = 14.72 L/s, 95% CI: 6.14-23.30, n = 2], forced expiratory volume in one second (FEV₁) [MD = 0.49 L, 95% CI: 0.17-0.81, n = 9], forced vital capacity (FVC) [MD = 0.55 L, 95% CI: 0.28-0.83, n = 8], FEV₁/FVC [MD = 8.02%, 95% CI: 5.77-10.28, n = 6]; indicated a significant reduction in psychological distress including depressive symptoms [SMD = -1.28, 95% CI: -2.25 to -0.31, n = 6], and anxiety [SMD = -1.54, 95% CI: -2.34 to -0.74, n = 7]. Subgroup analysis: patients receiving mindfulness-based respiratory function interventions indicated significant improvements in breathlessness [SMD = -0.53, 95% CI: -0.86 to -0.21], FEV₁ [MD = 0.28 L, 95% CI: 0.17-0.39], and FVC [MD = 1.29, 95% CI: 0.64-1.95], compared with those receiving respiratory function intervention. Mindfulness-based interventions did not demonstrate a statistically significant improvement in self-reported breathlessness compared to controls. However, subgroup analysis indicated that combining mindfulness with respiratory function training may offer additional benefits for alleviating breathlessness. Further high-quality RCTs are needed to determine the optimal intervention dosages and long-term impact of mindfulness-based interventions on improving breathlessness.