Crown Princess Mary Cancer Centre, Westmead, Australia.
Psycho-Oncology Co-operative Research Group, University of Sydney, Camperdown, Australia.
JCO Oncol Pract. 2021 Jun;17(6):e774-e784. doi: 10.1200/OP.20.00799. Epub 2021 Feb 11.
Fear of cancer recurrence (FCR) affects 50%-70% of cancer survivors. This multicenter, single-arm study sought to determine the participant-rated usefulness of an oncologist-delivered FCR intervention.
Women who completed treatment for early breast cancer (could be receiving endocrine therapy) with baseline FCR > 0 were invited to participate. FCR was measured using a validated 42-item FCR Inventory. The brief oncologist-delivered intervention entailed (1) FCR normalization; (2) provision of personalized prognostic information; (3) recurrence symptoms education, (4) advice on managing worry, and (5) referral to psycho-oncologist if FCR was high. FCR, depression, and anxiety were assessed preintervention (T0), at 1 week (T1), and 3 months (T2) postintervention. The primary outcome was participant-rated usefulness. Secondary outcomes included feasibility and efficacy.
Five oncologists delivered the intervention to 61/255 women invited. Mean age was 58 ± 12 years. Mean time since breast cancer diagnosis was 2.5 ± 1.3 years. Forty-three women (71%) were on adjuvant endocrine therapy. Of 58 women who completed T1 assessment, 56 (97%) found the intervention to be useful. FCR severity decreased significantly at T1 (F = 18.5, effect size = 0.39, < .0001) and T2 (F = 24, effect size = 0.68, < .0001) compared with baseline. There were no changes in unmet need or depression or anxiety. Mean consultation length was 22 minutes (range, 7-47 minutes), and mean intervention length was 8 minutes (range, 2-20 minutes). The intervention was perceived as useful and feasible by oncologists.
A brief oncologist-delivered intervention to address FCR is useful and feasible, and has preliminary efficacy in reducing FCR. Plans for a cluster randomized trial are underway.
癌症复发恐惧（FCR）影响 50%-70%的癌症幸存者。这项多中心、单臂研究旨在确定由肿瘤医生提供的 FCR 干预措施对参与者的有用性。
邀请完成早期乳腺癌治疗（可以接受内分泌治疗）且基线 FCR > 0 的女性参加。FCR 使用经过验证的 42 项 FCR 库存进行测量。简短的肿瘤医生提供的干预措施包括（1）FCR 正常化；（2）提供个性化的预后信息；（3）复发症状教育；（4）管理担忧的建议；（5）如果 FCR 高，转介给心理肿瘤学家。在干预前（T0）、干预后 1 周（T1）和 3 个月（T2）评估 FCR、抑郁和焦虑。主要结局是参与者对有用性的评价。次要结局包括可行性和疗效。
五位肿瘤医生对邀请的 255 位女性中的 61 位进行了干预。平均年龄为 58 ± 12 岁。乳腺癌诊断后平均时间为 2.5 ± 1.3 年。43 位女性（71%）正在接受辅助内分泌治疗。在完成 T1 评估的 58 位女性中，56 位（97%）认为干预措施有用。与基线相比，FCR 严重程度在 T1（F = 18.5，效应大小 = 0.39，<.0001）和 T2（F = 24，效应大小 = 0.68，<.0001）均显著降低。未满足的需求或抑郁或焦虑没有变化。平均咨询时间为 22 分钟（范围，7-47 分钟），平均干预时间为 8 分钟（范围，2-20 分钟）。肿瘤医生认为干预措施有用且可行。
针对 FCR 的简短肿瘤医生提供的干预措施是有用且可行的，并初步证明在降低 FCR 方面有效。正在计划进行一项集群随机试验。
