Nonpharmacological dyspnoea-relief strategies in lung cancer: a systematic review and network meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Acupressure: Hedges' g -1.96 (large effect); Fan therapy: Hedges' g -1.11 (large effect); Multicomponent: Hedges' g -1.01 (large effect)

• Primary Outcome: Dyspnoea score post-intervention

• Nnt Or Sensitivity: SUCRA rankings: Acupressure 98.7%, Fan therapy 83.7%, Multicomponent interventions 80.7%

• Confidence Interval: Acupressure: 95% CI -2.92 to -0.99; Fan: 95% CI -1.72 to -0.50; Multicomponent: 95% CI -1.49 to -0.52

Clinical Application

Nonpharmacological interventions are generally accessible and can complement standard care without significant resource requirements Relevant to Australian oncology and palliative care settings; interventions align with Cancer Australia guidelines emphasising supportive care; applicable across public and private healthcare systems Lung cancer patients with dyspnoea, including post-operative patients and those with pre-existing breathlessness

Abstract

BACKGROUND: Dyspnoea is a common and distressing symptom in lung cancer patients. While various dyspnoea-relief strategies show promise, their comparative effectiveness remains unclear. METHODS: We conducted a systematic review and network meta-analysis of randomised controlled trials on nonpharmacological dyspnoea-relief strategies in lung cancer patients, using studies published until 12 June 2025 from the databases PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. The primary outcome was dyspnoea score post-intervention. RESULTS: 4138 participants from 46 randomised controlled trials were included in the analysis. Among 10 nonpharmacological dyspnoea-relief strategies in lung cancer patients, acupressure (surface under the cumulative ranking curve (SUCRA) 98.7%, Hedges' g -1.96, 95% CI -2.92 to -0.99) demonstrated the highest efficacy, followed by fan (SUCRA 83.7%, Hedges' g -1.11, 95% CI -1.72 to -0.50), and multicomponent interventions (SUCRA 80.7%, Hedges' g -1.01, 95% CI -1.49 to -0.52). In post-operative lung cancer patients, multicomponent interventions (SUCRA 97.4%, Hedges' g -1.55, 95% CI -2.16 to -0.94) were the most effective, followed by cognitive behavioural therapy (SUCRA 74.8%, Hedges' g -0.90, 95% CI -1.75 to -0.05). For patients with pre-existing dyspnoea, acupressure (SUCRA 90.9%, Hedges' g -1.72, 95% CI -3.01 to -0.42) and fan therapy (SUCRA 77.3%, Hedges' g -1.18, 95% CI -2.10 to -0.27) were the top interventions. CONCLUSIONS: Acupressure is the primary strategy for alleviating dyspnoea in lung cancer patients, including those with pre-existing dyspnoea, followed by fan therapy, while multicomponent interventions are recommended for post-operative patients.

References

1. 1.Hu, G., Koirala, B., Young, L., Liang, C., Zhou, W., & Zhang, Q. (2026). Nonpharmacological dyspnoea-relief strategies in lung cancer: a systematic review and network meta-analysis. European Respiratory Review. https://doi.org/10.1016/j.jpainsymman.2023.03.002