Table 1 Characteristics of included studies
| Â | Reference | Country | Study Design | Paticipants | Intervention type,time | Intervention objective | Control | Measure Time | Main outcome | Evaluation tools | Grade |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Thyme 2009 | Sweden | RCT | Breast cancer patients uder radiotherapy Mean age = 59 years (Range: 37–69) IG: n = 20 CG: n = 21 | Individual art therapy, 5 weeks | Express feelings and thoughts | Without intervntion | Week 0,8,16 | Significant lower ratings of depression, anxiety, and somatic symptoms were reported for the art therapy group. | SCL-90: Axiety; Depression | High evidence |
2 | Monti 2006 | USA | RCT | Adult female cancer patients Mean age = 53.6 years IG:n = 56 CG:n = 55 | MBAT, 12 sessions 45 min each | Express their inner pain or feelings sufficiently | Wait-list controls | week 0,8,16 | The MBAT group demonstrated a significant improvements in key aspects of quality of life after intervention | SCL-90-R: Axiety; Depression SF-36: Quality of life | Moderate evidence |
3 | Svensk 2008 | Sweden | RCT | Women undergoing postoperative radiotherapy treatment for breast cancer IG: n = 20 CG: n = 21 | Individual art therapy, 5 sessions 5 weeks, 1 h/week | Offer time and space for expression and reflection; give support; reduce stress and supporting agency | Without intervntion | week 0,8,24 |  A significant increase in total quality of life in the art therapy group. | WHOQOL-BREF; EORTC-QLQ-BR23: Quality of life | High evidence |
4 | Jang 2016 | Korea | RCT | 24 breast cancer patients Mean age = 51.58 ± 5.72 years IG: n = 12 CG: n = 12 | MBAT, 12 sessions 45 min each | Express their inner pain or feelings sufficiently | Standard post-treatment clinic care | week 0,12 | Depression and anxiety decreased, health-related quality of life improved significantly in the MBAT group | PAI: Depression, Anxiety EORTCQLQ-C30: Quality of life, fatigue | Moderate evidence |
5 | Monti 2013 | USA | RCT | Women with brast cancer who were diagnosed beyond 6 months and winthin 3 years. IG::n = 98 CG::n = 93 | MBAT, 8 weeks | Provide an nonverbal mode of identifying and organizing internal and external representations of stressors and related emotions | Breast Cancer Support Group control arm (BCSG) | week 1,9,16 | MBAT is associated with significant, sustained benefits across a diverse range of breast cancer patients, particularly those with high stress levels | SCL-90: Anxiety, depression SF-36: Quality of life | Moderate evidence |
6 | Puig 2016 | USA | RCT | Women with Stage I and Stage II breast cancer Mean age = 51.4 ± 11.9 years IG: n = 20 CG: n = 19 | Individual creative art therapy, 4 weeks, 60 min each | To provide an opportunity for emotional expression and support | A delayed treatment of intervention | week 0,4 | Participants’ negative emotional states were improved in intervention group | POMS: Dpression, fatigue | Moderate evidence |
7 | ShuFen,Z 2017 | China | RCT | Cancer patients (male: n = 41; female: n = 45) IG: n = 43 CG: n = 43 | Group art therapy, 6 weeks | To express their emotions | Basic nursing care and pain care | week 0,2,4,6 | Mandala can decrease cancer patients’ anxiety | Self-rating anxiety scale (SAS): Anxiety | Moderate evidence |
8 | YuQiao,S 2017 | China | RCT | Breast cancer patients who need to accpet operation (Mean age: 38.2 ± 3.6 years) IG: n = 115 CG: n = 115 | Individual painting art therapy, After hospitalized 1–2 days, before and after operation | Establish well doctor-patient relationship and help patients release pressure through painting art therapy | Usual care after breast cancer surgery | week 0 After 1 months and 3 months after operation | Painting art therapy can improve patients’ quality of life | Cancer patients quality of life scale (self-make): Quality of life | Low evidence |