Younus Jawaid, Lock Michael, Vujovic Olga, Yu Edward, Malec Jitka, D'Souza David, Stitt Larry
Department of Medical Oncology, London Regional Cancer Program, 790 Commissioners Road East, London, Ontario, Canada N6A 4L6.
Department of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada.
Complement Ther Med. 2015 Aug;23(4):612-6. doi: 10.1016/j.ctim.2014.11.003. Epub 2014 Dec 5.
Therapeutic touch (TT) is a non-invasive commonly used complementary therapy. TT is based on the use of hand movements and detection of energy field congestion to correct imbalances. Improvement in subjective symptoms in a variety of clinical trials has been seen with TT. The effect of TT during radiotherapy for breast cancer is unknown.
Women undergoing adjuvant radiation for Stage I/II breast cancer post conservative surgery were recruited for this cohort study. TT treatments were administered three times per week following radiation therapy. Feasibility was defined as an a priori threshold of 15 of 17 patients completing all TT treatments. The preventive effectiveness of TT was evaluated by documenting the 'time to develop' and the 'worst grade of radiation' dermatitis. Toxicity was assessed using NCIC CTC V3 dermatitis scale. Cosmetic rating was performed using the EORTC Breast Cosmetic Rating. The quality of life, mood and energy, and fatigue were assessed by EORTC QLQ C30, POMS, and BFI, respectively. The parameters were assessed at baseline, and serially during treatment.
A total of 49 patients entered the study (17 in the TT Cohort and 32 in the Control Cohort). Median age in TT arm was 63 years and in control arm was 59 years. TT was considered feasible as all 17 patients screened completed TT treatment. There were no side effects observed with the TT treatments. In the TT Cohort, the worst grade of radiation dermatitis was grade II in nine patients (53%). Median time to develop the worst grade was 22 days. In the Control Cohort, the worst grade of radiation dermatitis was grade III in 1 patient. However, the most common toxicity grade was II in 15 patients (47%). Three patients did not develop any dermatitis. Median time to develop the worst grade in the control group was 31 days. There was no difference between cohorts for the overall EORTC cosmetic score and there was no significant difference in before and after study levels in quality of life, mood and fatigue.
This study is the first evaluation of TT in patients with breast cancer using objective measures. Although TT is feasible for the management of radiation induced dermatitis, we were not able to detect a significant benefit of TT on NCIC toxicity grade or time to develop the worst grade for radiation dermatitis. In addition, TT did not improve quality of life, mood, fatigue and overall cosmetic outcome.
治疗性触摸(TT)是一种常用的非侵入性辅助疗法。TT基于手部动作的运用以及对能量场拥堵的检测来纠正失衡。在各种临床试验中,TT已被证明能改善主观症状。TT在乳腺癌放疗期间的效果尚不清楚。
本队列研究招募了接受保乳手术后I/II期乳腺癌辅助放疗的女性。放疗后每周进行3次TT治疗。可行性定义为17名患者中有15名完成所有TT治疗这一预先设定的阈值。通过记录“出现时间”和“最严重的放射性”皮炎等级来评估TT的预防效果。使用加拿大国家癌症研究所(NCIC)常见毒性标准(CTC)V3版皮炎量表评估毒性。使用欧洲癌症研究与治疗组织(EORTC)乳房美容评分进行美容评级。分别通过EORTC QLQ C30、POMS和BFI评估生活质量、情绪和精力以及疲劳程度。在基线时以及治疗期间连续评估这些参数。
共有49名患者进入研究(TT组17名,对照组32名)。TT组的中位年龄为63岁,对照组为59岁。由于所有17名入选患者均完成了TT治疗,因此认为TT是可行的。TT治疗未观察到副作用。在TT组中,9名患者(53%)最严重的放射性皮炎为II级。出现最严重等级的中位时间为22天。在对照组中,1名患者最严重的放射性皮炎为III级。然而,最常见的毒性等级为II级,有15名患者(47%)。3名患者未出现任何皮炎。对照组出现最严重等级的中位时间为31天。两组之间的总体EORTC美容评分无差异,生活质量、情绪和疲劳程度在研究前后水平也无显著差异。
本研究是首次使用客观指标对乳腺癌患者进行TT评估。虽然TT对放射性皮炎的管理是可行的,但我们未能检测到TT对NCIC毒性等级或出现最严重放射性皮炎等级的时间有显著益处。此外,TT并未改善生活质量、情绪、疲劳程度和总体美容效果。