Methylphenidate in improving cancer-related fatigue: efficacy and safety – systematic review and meta-analysis of randomised controlled trials with trial sequential analysis

MPH demonstrates a modest improvement in CRF, with enhanced effects at 6 weeks. D-MPH shows superior therapeutic potential compared with racemic MPH. However, current evidence is insufficient to support widespread clinical application due to limitations in sample size and heterogeneity. Higher-quality RCTs are needed to confirm efficacy and safety profiles.