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采用新型综合方法在宫颈癌患者放化疗期间保留免疫功能。

Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach.

机构信息

Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.

出版信息

Brain Behav Immun. 2010 Nov;24(8):1231-40. doi: 10.1016/j.bbi.2010.06.014. Epub 2010 Jun 30.

Abstract

Patients receiving chemoradiation for cervical cancer are at risk for distress, chemoradiation-related side-effects, and immunosuppression. This prospective randomized clinical trial examined effects of a complementary therapy, Healing Touch (HT), versus relaxation training (RT) and usual care (UC) for (1) supporting cellular immunity, (2) improving mood and quality of life (QOL), and (3) reducing treatment-associated toxicities and treatment delay in cervical cancer patients receiving chemoradiation. Sixty women with stages IB1 to IVA cervical cancer were randomly assigned to receive UC or 4 ×/weekly individual sessions of either HT or RT immediately following radiation during their 6-week chemoradiation treatment. Patients completed psychosocial assessments and blood sampling before chemoradiation at baseline, weeks 4 and 6. Multilevel regression analyses using orthogonal contrasts tested for differences between treatment conditions over time. HT patients had a minimal decrease in natural killer cell cytotoxicity (NKCC) over the course of treatment whereas NKCC of RT and UC patients declined sharply during chemoradiation (group by time interaction: p = 0.018). HT patients showed greater decreases in two different indicators of depressed mood (CES-D depressed mood subscale and POMS depression scale) compared to RT and UC (group by time interactions: p<0.05). No between group differences were observed in QOL, treatment delay, or clinically-rated toxicities. HT may benefit cervical cancer patients by moderating effects of chemoradiation on depressed mood and cellular immunity. Effects of HT on toxicities, treatment delay, QOL, and fatigue were not observed. Long-term clinical implications of findings are not known.

摘要

接受宫颈癌放化疗的患者存在痛苦、放化疗相关副作用和免疫抑制的风险。这项前瞻性随机临床试验研究了补充疗法 Healing Touch(HT)对(1)支持细胞免疫、(2)改善情绪和生活质量(QOL)、(3)减少宫颈癌放化疗患者治疗相关毒性和治疗延迟的影响,将 HT 与放松训练(RT)和常规护理(UC)进行了比较。共有 60 名处于 IB1 至 IVA 期的宫颈癌患者随机分配接受 UC 或 HT 或 RT 治疗,在接受 6 周放化疗期间,每周接受 4 次个体治疗。患者在放化疗前、第 4 周和第 6 周完成心理社会评估和血液采样。使用正交对比的多层次回归分析测试了治疗条件随时间的差异。HT 患者在治疗过程中自然杀伤细胞细胞毒性(NKCC)的下降幅度最小,而 RT 和 UC 患者的 NKCC 在放化疗期间急剧下降(组间时间交互作用:p=0.018)。与 RT 和 UC 相比,HT 患者在两种不同的抑郁情绪指标(CES-D 抑郁情绪子量表和 POMS 抑郁量表)中表现出更大的下降(组间时间交互作用:p<0.05)。在 QOL、治疗延迟或临床评定毒性方面,三组之间没有差异。HT 可能通过减轻放化疗对情绪和细胞免疫的影响,使宫颈癌患者受益。HT 对毒性、治疗延迟、QOL 和疲劳的影响没有观察到。目前尚不清楚这些发现的长期临床意义。

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