Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel.
Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Psychooncology. 2022 Feb;31(2):207-218. doi: 10.1002/pon.5794. Epub 2021 Aug 26.
There is a need to explore how patient-tailored integrative oncology (IO) programs reduce emotional distress. This study set out to bridge the IO research gap between non-specific, quality of life-related and specific emotional-related concerns in chemotherapy-treated patients.
This pragmatic, prospective and preference-controlled study examined patients attending an integrative-physician consultation and weekly IO treatments during adjuvant/neo-adjuvant chemotherapy for localized cancer. Patients choosing to attend ≥4 IO sessions (highly adherent to integrative care, AIC) were compared to low AIC patients using the ESAS (Edmonton Symptom Assessment Scale) anxiety, depression and sleep; and the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) emotional functioning scale, at baseline, 6 and 12 weeks. Emotional distress was assessed by ESAS anxiety and depression, considered as the primary study outcomes.
Of 439 participants, 260 (59%) were high-AIC and 179 low-AIC, both with similar baseline demographic and cancer-related characteristics. At 6 weeks, high-AIC patients reported greater improvement on ESAS sleep (p = 0.044); within-group improvement on ESAS anxiety and; and EORTC emotional functioning. Compared with low-AIC, high-AIC patients showed greater improvement on ESAS depression (p = 0.022) and sleep (p = 0.015) in those with high baseline ESAS anxiety scores (≥7); and ESAS anxiety (p = 0.049) for patients moderately anxious (4-6) at baseline.
High-AIC was associated with significantly reduced anxiety, depression and sleep severity at 6 weeks, especially those with high-to-moderate baseline anxiety levels. These findings reduce the research gap, suggesting specific emotional-related effects of IO.
需要探索如何根据患者的情况制定个性化的综合肿瘤学(IO)方案,以减轻其情绪困扰。本研究旨在弥合 IO 研究中存在的差距,即关注化疗患者的非特异性、生活质量相关问题与特定情绪相关问题之间的差距。
本研究为一项实用、前瞻性且基于偏好的研究,纳入在辅助/新辅助化疗期间接受局部癌症治疗的患者,这些患者参加了综合医生咨询和每周的 IO 治疗。通过 ESAS(埃德蒙顿症状评估量表)焦虑、抑郁和睡眠量表,以及 EORTC QLQ-C30(欧洲癌症研究与治疗组织生活质量问卷)情绪功能量表,在基线、6 周和 12 周时,比较选择参加≥4 次 IO 治疗(高度接受综合治疗,AIC)的患者与低 AIC 患者。采用 ESAS 焦虑和抑郁评估情绪困扰,这被认为是主要的研究结果。
在 439 名参与者中,260 名(59%)为高 AIC,179 名(41%)为低 AIC,两组的基线人口统计学和癌症相关特征相似。在 6 周时,高 AIC 患者报告 ESAS 睡眠(p=0.044)、ESAS 焦虑和 EORTC 情绪功能均有更大的改善。与低 AIC 相比,高 AIC 患者在基线 ESAS 焦虑评分≥7 分的患者中,ESAS 抑郁和睡眠(p=0.015)以及 ESAS 焦虑(p=0.022)改善更为明显;在基线时焦虑程度为 4-6 分的中度焦虑患者中,ESAS 焦虑(p=0.049)也得到了改善。
在 6 周时,高 AIC 与焦虑、抑郁和睡眠严重程度显著降低相关,尤其是那些基线时焦虑程度较高或中度的患者。这些发现缩小了研究差距,表明 IO 具有特定的情绪相关作用。