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详细咨询与生活回顾对非转移性乳腺癌女性患者的心理社会、认知及身体影响

Psychosocial, Cognitive, and Physical Impact of Elaborate Consultations and Life Review in Female Patients with Non-Metastasized Breast Cancer.

作者信息

Thronicke Anja, Kröz Matthias, Merkle Antje, Matthes Harald, Herbstreit Cornelia, Schad Friedemann

出版信息

Complement Med Res. 2018;25(2):92-101. doi: 10.1159/000486672. Epub 2018 Apr 18.

DOI:10.1159/000486672
PMID:29656290
Abstract

BACKGROUND

Elaborate consultations and life review (ECLR) has been regularly applied in patients of various cancer entities and stages within Anthroposophic-integrative oncology concepts. However, a lack of systematic research in this field has been detected. To close this gap of knowledge, we evaluated the impact of ECLR in patients with non-metastasized breast cancer before, during, and after primary oncological treatment.

METHODS

Patient-reported outcome measures were evaluated by analyzing European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) in patients with non-metastasized breast cancer who had received either oncological standard therapy alone or in combination with ECLR.

RESULTS

95 female patients were eligible for questionnaire analysis (median age 58 years). Adjusted multivariable linear regression analysis revealed that ECLR was associated with significant improvements in medium-term global health/quality of life and emotional, social, and cognitive functioning. Furthermore, ECLR was associated with significant reductions of short-term appetite loss burden, pain, and short- and medium-term financial difficulties. Subgroup analyses revealed significant improvements in pivotal quality-of-life aspects including fatigue (p = 0.002) in chemotherapy-treated patients after ECLR.

CONCLUSIONS

12 months of surveillance of breast cancer patients reveals medium-term recovery of the global health status/quality of life and cognitive and psychosocial well-being associated with ECLR. In addition, our data indicate a possible association between ECLR and reduced short-term fatigue burden, which has to be re-confirmed prospectively in a larger study cohort. As long-term cancer survivors develop psychological symptoms similar to patients with chronic diseases, prospective studies should evaluate the impact of ECLR on the psychosocial well-being in these patients.

摘要

背景

在人智学整合肿瘤学概念中,详细咨询与生活回顾(ECLR)已被常规应用于各种癌症类型和分期的患者。然而,已发现该领域缺乏系统研究。为填补这一知识空白,我们评估了ECLR在非转移性乳腺癌患者原发性肿瘤治疗前、治疗期间及治疗后的影响。

方法

通过分析接受单纯肿瘤标准治疗或联合ECLR的非转移性乳腺癌患者的欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)来评估患者报告的结局指标。

结果

95名女性患者符合问卷分析条件(中位年龄58岁)。调整后的多变量线性回归分析显示,ECLR与中期整体健康/生活质量以及情感、社会和认知功能的显著改善相关。此外,ECLR与短期食欲减退负担、疼痛以及短期和中期经济困难的显著减轻相关。亚组分析显示,ECLR后化疗患者在关键生活质量方面有显著改善,包括疲劳(p = 0.002)。

结论

对乳腺癌患者进行12个月的监测发现,与ECLR相关的整体健康状况/生活质量以及认知和心理社会幸福感在中期有所恢复。此外,我们的数据表明ECLR与短期疲劳负担减轻之间可能存在关联,这有待在更大的研究队列中进行前瞻性再次确认。由于长期癌症幸存者会出现与慢性病患者相似的心理症状,前瞻性研究应评估ECLR对这些患者心理社会幸福感的影响。

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