Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Haifa, Israel.
Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
J Cancer Res Clin Oncol. 2018 Sep;144(9):1825-1833. doi: 10.1007/s00432-018-2700-y. Epub 2018 Jul 6.
To examine the impact of a complementary/integrative medicine (CIM) program on quality of life (QoL)-related concerns among patients scheduled for chemotherapy for breast and gynecologic cancer.
Chemotherapy-naïve patients were referred by their oncology healthcare professional to an integrative oncology program, where CIM is provided as part of palliative/supportive care. CIM treatments were tailored to patients' preferences and leading concerns, and for most included acupuncture and mind-body-spirit modalities, which were usually co-administered in the week preceding the first chemotherapy cycle. Patients attending the program were considered part of the treatment group; those who chose to receive only standard supportive care as controls. Assessment of quantitative outcomes was conducted during the week before chemotherapy; at 24 h before and after the treatment; and at 1 week post treatment. For this purpose, the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Well-being questionnaire (MYCAW) were used. Qualitative assessment was based on short narratives at the end of the follow-up MYCAW questionnaire, which were analyzed with ATLAS.Ti software for systematic coding.
Of the 55 patients referred, 31 (56%) underwent CIM treatments, with 24 controls. Both groups had similar baseline demographic and cancer-related characteristics. QOL-related outcomes were significantly less impaired following CIM treatments for ESAS fatigue scores (P = 0.013), depression (P = 0.005), and feeling of well-being (P = 0.027); and MYCAW scores for well-being (P = 0.005) and emotional distress (P = 0.02). Qualitative analysis detected both specific and non-specific effects of the CIM treatment regimen, most describing a reduction in pre-chemotherapy anxiety.
A patient-tailored CIM program, initiated within a week of the first chemotherapy cycle, may help reduce the severity of fatigue, depression, and impaired well-being among patients with breast and gynecological cancers.
研究补充/整合医学（CIM）方案对拟接受乳腺癌和妇科癌症化疗患者的生活质量（QoL）相关问题的影响。
肿瘤学医护人员将化疗初治患者转介到整合肿瘤学项目，在此项目中，CIM 作为姑息/支持性护理的一部分提供。CIM 治疗根据患者的偏好和主要关注点量身定制，对于大多数患者包括针灸和身心精神疗法，这些疗法通常在第一个化疗周期前一周内联合进行。参加该项目的患者被视为治疗组；选择仅接受标准支持性护理的患者作为对照组。在化疗前一周内进行定量结果评估；在治疗前 24 小时和治疗后进行评估；并在治疗后 1 周进行评估。为此，使用了埃德蒙顿症状评估量表（ESAS）和自我评估关注和幸福感问卷（MYCAW）。定性评估基于随访 MYCAW 问卷结束时的简短叙述，使用 ATLAS.Ti 软件对这些叙述进行系统编码。
在转介的 55 名患者中，有 31 名（56%）接受了 CIM 治疗，有 24 名对照组。两组患者的基线人口统计学和癌症相关特征相似。CIM 治疗后，ESAS 疲劳评分（P=0.013）、抑郁评分（P=0.005）和幸福感评分（P=0.027），以及 MYCAW 评分中的幸福感评分（P=0.005）和情绪困扰评分（P=0.02）显著降低，提示 QOL 相关结果得到改善。定性分析检测到 CIM 治疗方案的特定和非特定作用，大多数描述减轻了化疗前的焦虑。
在第一个化疗周期前一周内启动的个体化 CIM 方案可能有助于减轻乳腺癌和妇科癌症患者的疲劳、抑郁和幸福感受损的严重程度。
