Research Institute Havelhöhe (FIH), Berlin, Germany.
Integr Cancer Ther. 2013 Jul;12(4):301-11. doi: 10.1177/1534735412464552. Epub 2012 Dec 21.
HYPOTHESE: Cancer-related fatigue (CRF) and sleep disorders are some of the most wearing and common symptoms in disease-free breast cancer patients (BC). Aerobic training (AT) is the treatment with the best available evidence, even though it seems to be insufficient with regards to improvements in cognitive fatigue. We introduced a new multimodal therapy concept (MM) consisting of psycho-, sleep-education and new approaches based on anthroposophic medicine such as eurythmy and painting therapy.
This pilot study will test the implementation of MM and yield first results of the MM and AE in our centres.
31 out of 34 patients suffering from BC and CRF were fully assessed in a ten-week intervention study. 21 patients chose MM and 10 decided on AT. CRF was measured with the help of the Cancer Fatigue Scale (CFS-D), and the global quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). We also captured autonomic regulation (aR) and patients' satisfaction with questionnaires. Statistical analysis was done with SAS 9.1.3 for windows.
The new MM therapy can be implemented with high satisfaction among patients. Significant improvements were found in the MM group with regards to CFS-D, global quality of sleep, sleep efficiency (PSQI), aR and rest/activity regulation compared to baseline (all p<0.05). In the AT group aR orthostatic-circulatory and rest/activity regulation improved significantly (p<0.05), too. However, no improvement in cognitive fatigue was seen in either group.
The multimodal therapy concept was feasible and improved cancer fatigue, sleep quality, autonomic and rest-/activity regulation in breast cancer patients. It may therefore constitute a valuable treatment option in addition to aerobic training for BC patients with CRF. A further study with larger sample size needs to be carried out to assess the efficacy of combined multimodal-aerobic therapy.
假设：癌症相关疲劳（CRF）和睡眠障碍是无疾病乳腺癌患者（BC）最常见和最令人疲倦的症状之一。有氧运动训练（AT）是最有证据的治疗方法，尽管它似乎不足以改善认知疲劳。我们引入了一种新的多模式治疗概念（MM），包括心理、睡眠教育以及基于人智学的新方法，如 eurhythmy 和绘画疗法。
这项初步研究将测试 MM 的实施，并在我们的中心获得 MM 和 AE 的初步结果。
34 名患有 BC 和 CRF 的患者中有 31 名在为期 10 周的干预研究中接受了全面评估。21 名患者选择 MM，10 名患者选择 AT。CRF 通过癌症疲劳量表（CFS-D）进行测量，睡眠质量通过匹兹堡睡眠质量指数（PSQI）进行测量。我们还通过问卷捕获自主调节（aR）和患者满意度。统计分析使用 SAS 9.1.3 for windows 进行。
新的 MM 治疗方法可以得到患者的高度满意。与基线相比，MM 组在 CFS-D、整体睡眠质量、睡眠效率（PSQI）、aR 和休息/活动调节方面均有显著改善（均 p<0.05）。在 AT 组中，自主循环和休息/活动调节也有显著改善（p<0.05）。然而，两组的认知疲劳均未得到改善。
多模式治疗概念是可行的，可以改善乳腺癌患者的癌症疲劳、睡眠质量、自主和休息/活动调节。因此，它可能是除有氧运动训练外，治疗 CRF 乳腺癌患者的另一种有价值的治疗选择。需要进行更大样本量的进一步研究，以评估联合多模式-有氧运动治疗的疗效。
