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非转移性乳腺癌治疗后采用水疗的全球支持性皮肤护理方案的疗效:一项随机对照研究。

Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study.

作者信息

Dalenc F, Ribet V, Rossi A B, Guyonnaud J, Bernard-Marty C, de Lafontan B, Salas S, Ranc Royo A-L, Sarda C, Levasseur N, Massabeau C, Levecq J-M, Dulguerova P, Guerrero D, Sibaud V

机构信息

Institut Claudius Regaud, Cancer University Institute-Oncopole, Toulouse Cedex 9, Toulouse, France.

Clinical Research Centre, Pierre Fabre Dermo-Cosmetique, Toulouse Cedex 3, France.

出版信息

Eur J Cancer Care (Engl). 2018 Jan;27(1). doi: 10.1111/ecc.12735. Epub 2017 Aug 22.

Abstract

This study investigated the efficacy of post-treatment hydrotherapy as supportive care for management of persistent/long-lasting dermatologic adverse events (dAEs) induced in breast cancer survivors by adjuvant therapy, and its impact on quality of life (QoL). Patients in complete remission after standardised (neo)adjuvant chemotherapy, surgery and radiotherapy combination treatment for infiltrating HR+/HER2-breast carcinoma were enrolled in this randomised, multicentre controlled study 1-5 weeks after completing radiotherapy. The control group (CG, n = 33) received best supportive care and the treatment group (HG, n = 35) received 3-weeks of specific hydrotherapy. The primary criterion was change in QoL (QLQ-BR23) after hydrotherapy. Clinical grading of dAEs, cancer-related QoL (QLQ-C30), dermatologic QoL (DLQI) and general psychological well-being (PGWBI) were assessed. Significant dAEs were found at inclusion in both groups (n = 261). Most items showed significantly greater improvement in the HG versus CG group: QLQ-BR23 (breast [p = .0001] and arm symptoms [p = .0015], systemic therapy side effects [p = .0044], body image [p = .0139]), some dAE grading, DLQI (p = .0002) and PGWBI (p = .0028). Xerosis (88% of patients at inclusion) completely healed in all HG patients. Specific hydrotherapy is an effective supportive care for highly prevalent and long-lasting dAEs occurring after early breast cancer treatment, including chemotherapy, and leads to improved QoL and dermatologic toxicities.

摘要

本研究调查了治疗后水疗作为辅助治疗手段对乳腺癌幸存者因辅助治疗引起的持续性/长期皮肤不良事件(dAEs)的管理效果及其对生活质量(QoL)的影响。浸润性HR+/HER2-乳腺癌患者在接受标准化(新)辅助化疗、手术和放疗联合治疗后完全缓解,在完成放疗后1至5周纳入本随机、多中心对照研究。对照组(CG,n = 33)接受最佳支持治疗,治疗组(HG,n = 35)接受为期3周的特定水疗。主要标准是水疗后生活质量(QLQ-BR23)的变化。评估了dAEs的临床分级、癌症相关生活质量(QLQ-C30)、皮肤生活质量(DLQI)和总体心理健康(PGWBI)。两组在纳入时均发现有显著的dAEs(n = 261)。大多数项目在HG组比CG组有更显著的改善:QLQ-BR23(乳房[p = .0001]和手臂症状[p = .0015]、全身治疗副作用[p = .0044]、身体形象[p = .0139])、一些dAE分级、DLQI(p = .0002)和PGWBI(p = .0028)。所有HG患者的皮肤干燥(纳入时88%的患者)完全愈合。特定水疗是对早期乳腺癌治疗(包括化疗)后发生的高度普遍且持久的dAEs的有效支持治疗,可改善生活质量和皮肤毒性。

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