Kwiatkowski Fabrice, Dessenne Pascal, Laquet Claire, Daures Jean-Pierre, Gay-Bellile Mathilde, Bignon Yves-Jean
Laboratoire d'oncologie moléculaire, Centre Jean Perrin, 58 rue Montalembert, 63011, Clermont-Ferrand Cedex, France.
UPRES 2425, Décision médicale personnalisée, Montpellier, France.
Trials. 2016 Oct 21;17(1):509. doi: 10.1186/s13063-016-1642-4.
Young women exposed to a high hereditary breast and ovarian cancer (HBOC) risk are particularly vulnerable. They are ignored by health prevention measures but exposed to a stream of contradictory information (medicine, media, Internet). They may feel concerned about surgical prevention issues at a key moment of their identity construction (self, relationship, sexuality). We designed a special psychoeducational intervention to help these women cope better with these difficulties.
METHODS/DESIGN: The BRACAVENIR study consists of a prospective, randomized superiority phase II trial with a wait list control group. Participants are childless young female counselees (aged 18-30 years) seen at the oncogenetics department of the Centre Jean Perrin and belonging to HBOC families either with or without BRCA mutations. They will be invited to attend a weekend group session at a spa resort and to participate in short expert conferences and focus group activities (group sharing, Moreno role game) supervised by a psychotherapist. Two sessions separated by a 6-month delay (wait list) will enable us to evaluate the intervention's effect by comparing questionnaire scores between the 6-month time points. The main endpoint is an increase of the Herth Hope Index by at least 1 SD. Secondary endpoints are self-esteem, anxiety trait, anxiety state, coping, and quality of life. With a one-sided α = 0.05 and β = 0.20, 12 participants will be needed by group, plus an additional 2 in anticipation of dropouts. Participants will be randomized 1:1 to the first or the second session so that the groups will be comparable.
The intent of this trial is to bridge the gap on a psychosocial level in these young women with HBOC. A particularity of the design is the use of a waiting list, which should allow for avoiding major bias. The intervention consists of a short session that could be proposed to other young counselees if successful. The results may bring complementary information to facilitate the intervention and also influence the contents of the oncogenetic consultation.
Ethics committee CPP SUD-EST-6: IRB00008526. Registered on 18 March 2016. ClinicalTrials.gov identifier: NCT02705924 . Registered on 2 March 2016.
面临高遗传性乳腺癌和卵巢癌(HBOC)风险的年轻女性特别脆弱。她们被健康预防措施忽视,但却接触到一连串相互矛盾的信息(医学、媒体、互联网)。在她们身份构建的关键时期(自我、人际关系、性取向),她们可能会对手术预防问题感到担忧。我们设计了一项特殊的心理教育干预措施,以帮助这些女性更好地应对这些困难。
方法/设计:BRACAVENIR研究包括一项前瞻性、随机优势II期试验,设有一个等待名单对照组。参与者是在让·佩兰中心肿瘤遗传学部门就诊的未育年轻女性咨询对象(年龄18 - 30岁),属于有或没有BRCA突变的HBOC家族。她们将被邀请参加一个温泉度假胜地的周末小组会议,并参与由心理治疗师监督的简短专家会议和焦点小组活动(小组分享、莫雷诺角色扮演)。两次间隔6个月(等待名单)的会议将使我们能够通过比较6个月时间点之间的问卷分数来评估干预效果。主要终点是赫思希望指数至少增加1个标准差。次要终点是自尊、特质焦虑、状态焦虑、应对方式和生活质量。单侧α = 0.05,β = 0.20,每组需要12名参与者,另外预计有2名参与者以防退出。参与者将以1:1的比例随机分配到第一次或第二次会议,以便两组具有可比性。
该试验的目的是在这些患有HBOC的年轻女性的心理社会层面上弥合差距。该设计的一个特点是使用等待名单,这应该有助于避免重大偏差。如果成功,干预措施包括一个简短的会议,可以向其他年轻咨询对象推荐。研究结果可能会带来补充信息,以促进干预,并影响肿瘤遗传学咨询的内容。
伦理委员会CPP SUD-EST-6:IRB00008526。于2016年3月18日注册。ClinicalTrials.gov标识符:NCT02705924。于2016年3月2日注册。