Milbury Kathrin, Mallaiah Smitha, Mahajan Anita, Armstrong Terri, Weathers Shioa-Pei, Moss Kathryn E, Goktepe Nazli, Spelman Amy, Cohen Lorenzo
1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Integr Cancer Ther. 2018 Jun;17(2):332-336. doi: 10.1177/1534735417689882. Epub 2017 Feb 2.
Despite their high symptom burden and poor prognosis, evidence-based supportive care interventions for adults with high-grade glioma (HGG) and their caregivers are lacking. Thus, we aimed to establish feasibility of a patient-caregiver dyadic yoga program (DYP) for newly diagnosed HGG patients and their family caregivers targeting quality-of-life (QOL) outcomes.
In this single-arm pilot trial, dyads participated in a 12-session DYP program across the course of patients' radiotherapy. The intervention focused on breathing exercises, gentle movements, and guided meditations. We tracked feasibility data and assessed levels of cancer-related symptoms (MD Anderson Symptom Inventory [MDASI]), depressive symptoms (Centers for Epidemiological Studies-Depression scale), fatigue (Brief Fatigue Inventory), sleep disturbances (Pittsburgh Sleep Quality Index [PSQI]), and overall mental and physical QOL (36-item Short-Form Survey [SF-36]) at baseline and post-DYP, which was at the end of radiotherapy.
We approached 6 dyads of which 5 dyads (86%) consented and completed all 12 sessions and pre/post assessments. All patients (mean age: 52 years, 80% female, 80% grade IV) and caregivers (mean age: 58 years, 80% female, 60% spouses) perceived benefit from the program. Paired t tests revealed a marginally significant, yet clinically meaningful, decrease in patient's cancer symptoms ( t = 2.32, P = .08; MDASI mean; pre = 1.75, post = 1.04). There were clinically significant reductions in patient sleep disturbances (PSQI mean: pre = 10.75, post = 8.00) and improvements in patient and caregiver mental QOL (MCS of SF-36 mean: pre = 42.35, post = 52.34, and pre = 45.14, post = 51.43, respectively).
This novel supportive care program appears to be safe, feasible, acceptable, and subjectively useful for HGG patients and their caregivers. There was also preliminary evidence regarding QOL treatment gains for both patients and caregivers.
尽管高级别胶质瘤（HGG）成人患者及其照护者症状负担重且预后差，但缺乏基于证据的支持性护理干预措施。因此，我们旨在针对新诊断的HGG患者及其家庭照护者，建立以生活质量（QOL）为目标的患者-照护者二元瑜伽项目（DYP）的可行性。
在这项单臂试点试验中，二元组在患者放疗期间参加了为期12节的DYP项目。干预措施侧重于呼吸练习、轻柔运动和引导式冥想。我们跟踪了可行性数据，并在基线和DYP结束时（即放疗结束时）评估了癌症相关症状水平（MD安德森症状量表[MDASI]）、抑郁症状（流行病学研究中心抑郁量表）、疲劳（简明疲劳量表）、睡眠障碍（匹兹堡睡眠质量指数[PSQI]）以及整体心理和生理生活质量（36项简短问卷[SF-36]）。
我们接触了6个二元组，其中5个二元组（86%）同意并完成了所有12节课程及前后评估。所有患者（平均年龄：52岁，80%为女性，80%为四级）和照护者（平均年龄：58岁，80%为女性，60%为配偶）都认为该项目有益。配对t检验显示患者的癌症症状有轻微但具有临床意义的下降（t = 2.32，P = 0.08；MDASI平均值；术前 = 1.75，术后 = 1.04）。患者的睡眠障碍有临床显著改善（PSQI平均值：术前 = 10.75，术后 = 8.00），患者和照护者的心理生活质量也有改善（SF-36的MCS平均值：术前分别为42.35和45.14，术后分别为52.34和51.43）。
这个新颖的支持性护理项目似乎对HGG患者及其照护者是安全、可行、可接受且主观上有用的。同时也有关于患者和照护者生活质量治疗获益的初步证据。
