Comparative efficacy of non-pharmacological adjuvant therapies for quality of life in the patients with breast cancer receiving chemo- or radio-therapy A protocol for systematic review and Bayesian network meta-analysis

Background: Breast cancer is the most frequently diagnosed cancer in women worldwide. When treated by chemotherapy and/or radiotherapy, there are various non-pharmacological adjuvant therapies (NPATs) recommended for helping the patients with breast cancer alleviate multiple side effects induced by chemotherapy and/or radiotherapy and improve quality of life (QoL). However, the existing evidence does not suggest the therapy with the best effectiveness among a variety of NPATs. This study is to compare the effectiveness of different NPATs on QoL in the patients with breast cancer using Bayesian network meta-analysis (NMA). Methods and analysis: We will conduct a comprehensive search strategy in the relevant databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, World Health Organization (WHO), International Clinical Trials Registry Platform (ICTRP) search portal (http://apps.who.int/trialsearch/Default.aspx), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Data). The random or quasi-random controlled trails that compare different NPATs in patient with breast cancer who received the chemotherapy and/or radiotherapy will be included. We only focus on the outcome of QoL which can be assessed by a series of tools. The risk of bias for included studies will be appraised using the Cochrane Collaboration's tool for assessing risk of bias. The standard pairwise meta-analysis and a Bayesian NMA will be conducted. Ethics and dissemination: Ethical approval and patient consent are not required since this is an NMA based on published studies. We will submit our NMA to a peer-reviewed journal for publication.