Effects of the CALM intervention on cancer-related fatigue and heart rate variability in NSCLC: a randomized trial

Objectives: To evaluate the effects of CALM intervention on cancer-related fatigue (CRF), quality of life (QOL), and heart rate variability (HRV) in non-small cell lung cancer (NSCLC) patients. Methods: A total of 153 NSCLC patients were enrolled in the study. Participants were randomly assigned to the CALM group and usual care (UC) group. Patients in the CALM group were received 6 CALM intervention sessions over a 12-week period and evaluated using CRF, QOL and HRV at baseline (T0) and after 2, 4, and 6 intervention sessions. Results: The CALM group showed significant differences in total CRF, behavioral/daily life CRF, emotional/affective CRF, sensory/physical CRF, cognitive CRF and QOL before and after CALM intervention sessions (F = 643.47, F = 208.34, F = 354.52, F = 285.69, F = 334.29, F = 245.77, p < 0.001). The CALM group showed significant increases in standard deviation of normal R-R interval (SDNN) and high-frequency power (HF) (z = -4.94, p < 0.001,z = -4.30, p < 0.001). Significant negative correlations were observed between CRF and SDNN, HF and QOL across all participants. Conclusions: The CALM intervention had a positive impact on overall physical and mental health, fatigue reduction, quality of life and autonomic dysfunction in NSCLC patients. Heart rate variability may serve as an observational indicator of physical and mental health.