The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India.
Psychooncology. 2019 Mar;28(3):615-621. doi: 10.1002/pon.4991. Epub 2019 Feb 7.
Thoracic radiotherapy (TRT) may result in toxicities that are associated with performance declines and poor quality of life (QOL) for patients and their family caregivers. The purpose of this randomized controlled trial was to establish feasibility and preliminary efficacy of a dyadic yoga (DY) intervention as a supportive care strategy.
Patients with stage I to III non-small cell lung or esophageal cancer undergoing TRT and their caregivers (N = 26 dyads) were randomized to a 15-session DY or a waitlist control (WLC) group. Prior to TRT and randomization, both groups completed measures of QOL (SF-36) and depressive symptoms (CES-D). Patients also completed the 6-minute walk test (6MWT). Dyads were reassessed on the last day of TRT and 3 months later.
A priori feasibility criteria were met regarding consent (68%), adherence (80%), and retention (81%) rates. Controlling for relevant covariates, multilevel modeling analyses revealed significant clinical improvements for patients in the DY group compared with the WLC group for the 6MWT (means: DY = 473 m vs WLC = 397 m, d = 1.19) and SF-36 physical function (means: DY = 38.77 vs WLC = 30.88; d = .66) and social function (means: DY = 45.24 vs WLC = 39.09; d = .44) across the follow-up period. Caregivers in the DY group reported marginally clinically significant improvements in SF-36 vitality (means: DY = 53.05 vs WLC = 48.84; d = .39) and role performance (means: DY = 52.78 vs WLC = 48.59; d = .51) relative to those in the WLC group.
This novel supportive care program appears to be feasible and beneficial for patients undergoing TRT and their caregivers. A larger efficacy trial with a more stringent control group is warranted.
胸部放射治疗（TRT）可能导致毒性反应，从而导致患者及其家庭照顾者的表现下降和生活质量（QOL）下降。本随机对照试验的目的是确定双联瑜伽（DY）干预作为支持性护理策略的可行性和初步疗效。
接受 TRT 的 I 期至 III 期非小细胞肺癌或食管癌患者及其照顾者（N=26 对）被随机分为 15 节 DY 或候补名单对照（WLC）组。在 TRT 之前和随机分组之前，两组都完成了生活质量（SF-36）和抑郁症状（CES-D）的测量。患者还完成了 6 分钟步行测试（6MWT）。在 TRT 的最后一天和 3 个月后，对 dyads 进行重新评估。
事先设定的可行性标准是关于同意（68%）、依从性（80%）和保留率（81%）。控制相关协变量后，多层次建模分析显示，与 WLC 组相比，DY 组患者在 6MWT（均值：DY=473m 与 WLC=397m，d=1.19）和 SF-36 身体功能（均值：DY=38.77 与 WLC=30.88；d=0.66）和社会功能（均值：DY=45.24 与 WLC=39.09；d=0.44）方面均有显著的临床改善。DY 组的照顾者报告 SF-36 活力（均值：DY=53.05 与 WLC=48.84；d=0.39）和角色表现（均值：DY=52.78 与 WLC=48.59；d=0.51）方面有轻微的临床显著改善。
这种新的支持性护理方案似乎对接受 TRT 的患者及其照顾者是可行和有益的。需要进行更大规模的、更严格对照的疗效试验。
