Efficacy of Mindfulness-Based Interventions for Reducing Cancer-Related Fatigue: A Systematic Review and Meta-Analysis.

Background: Cancer-related fatigue (CRF) is a common and distressing symptom among patients with cancer. Although mindfulness-based interventions (MBIs) are increasingly applied for CRF management, evidence regarding their efficacy remains inconsistent.

Aims: This systematic review and meta-analysis aimed to evaluate the efficacy of MBIs in reducing CRF.

Methods: PubMed, EMBASE, Web of Science, Cochrane, and CINAHL were comprehensively searched from database inception to August 31, 2025, for randomized controlled trials (RCTs) involving patients with cancer who received MBIs. The primary outcome of interest was fatigue. The risk of bias was assessed using the Cochrane risk-of-bias 2.0 tool. A meta-analysis was performed using a random-effects model, and standardized mean differences (SMDs) with 95% confidence intervals (CI) were calculated. Subgroup analyses, meta-regressions, publication bias assessments, and sensitivity analyses were also performed.

Results: A total of 29 RCTs involving 3178 participants were included. Compared with control interventions, MBIs were associated with significantly lower fatigue levels (SMD = -0.89; 95% CI: -1.23 to -0.55, p < 0.001). However, substantial heterogeneity was observed (I2 = 87.3%). Sample size significantly moderated the results. Although publication bias was detected, the adjusted effect size remained significant. Sensitivity analysis confirmed the robustness of the findings.

Conclusions: This study demonstrates that MBIs are an efficacious approach for significantly reducing fatigue among patients with cancer, supporting the role and broader application of nonpharmacological strategies in managing CRF. However, substantial between-study heterogeneity, moderate certainty of evidence, and indications of publication bias warrant cautious interpretation of the pooled estimates.