Current Evidence and Clinical Outcomes of Neuro-oncology Rehabilitation: A Systematic Review

Abstract

Background: Adults with brain tumours can experience motor, cognitive, psychological and participation limitations across surgery, active treatment and survivorship, but rehabilitation evidence is heterogeneous. Objective: To synthesise clinical outcomes, harms and implementation results of structured adult neuro-oncology rehabilitation without statistical meta-analysis. Methods: Openly accessible PubMed/PMC record pages, ClinicalTrials.gov records, backward citations and related reports were searched through 30 June 2026 for English-language studies published from 1 January 2000 to 30 June 2026. Randomised, non-randomised and longitudinal rehabilitation studies in adults with intracranial tumours were eligible. One reviewer screened, extracted and appraised records. RoB 2, ROBINS-I and JBI domains informed outcome-level narrative certainty. Results: Ninety-eight record instances yielded 84 unique screened records, 25 retrieved full reports and 20 included studies. Multidisciplinary cohorts consistently reported functional gains, but lacked comparable controls. Exercise, cognitive and psychological programmes were generally feasible in selected patients; controlled clinical effects were mixed. A telepsychology trial improved short-term depression, a cognitive strategy trial improved subjective memory outcomes, and one small adaptive trial showed a large short-term fatigue reduction. Attrition was substantial in several high-grade-glioma programmes. Certainty was low or very low for most outcomes and moderate only for the narrow severe-fatigue question. Conclusions: Rehabilitation is deliverable across inpatient, outpatient, home and telehealth settings and may improve selected functional and symptom outcomes, but comparative effectiveness and uncommon harms remain uncertain. Multicentre trials with core outcomes, prespecified estimands and systematic adverse-event reporting are needed.