风险和生活方式因素对采用整合医学治疗乳腺癌和妇科癌症患者的治疗目标的影响。
Impact of risk and lifestyle factors on therapy goals in the treatment of breast cancer and gynecological cancer patients with integrative medicine.
作者信息
Seitz Katharina, Theuser Anna-Katharin, Antoniadis Sophia, Beckmann Matthias W, Beierlein Milena, Brückner L, Au Katharina, Hack Carolin C
机构信息
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-European Metropolitan Area Nuernberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuernberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
Bavarian Cancer Research Center, BZKF, Erlangen, Deutschland.
出版信息
Arch Gynecol Obstet. 2025 Jun;311(6):1683-1695. doi: 10.1007/s00404-025-08002-w. Epub 2025 Apr 9.
BACKGROUND
As a result of advancements in the diagnosis and therapy of cancer, the prognosis for cancer patients has significantly improved. The benefits of a significantly enhanced survival time lead to a more extensive concern with quality of life and managing the side effects during oncological treatment. Implementing integrative medicine strategies has been found to reduce the side effects of therapy and disease. In 2021 the S3 guideline on complementary medicine in oncology was published for the first time, which takes a stand on the most common aspects of complementary and integrative medicine in Germany. The aim was to see whether a previous healthy life style impacts the success of integrative medicine for patients.
METHODS
Within the framework of a cross-sectional study over 15 months, 120 cancer patients were monitored at a standardized integrative medicine consultancy service at the University Integrative Medicine Center of the University Hospital Erlangen, Department of Gynecology and Obstetrics. The basic questionnaire consisted of questions on socioeconomic background information, lifestyle factors, such as dietary habits or smoking behavior, as well as information on the gynecological situation. Furthermore, an evaluation based on patient-reported therapy goals concerning the reduction of side effects of conventional cancer treatments, enhancement of disease-related quality of life and better stress and disease management, active participation in cancer treatments, mind-body stabilization, and improvements in coping strategies were assessed. In addition, the impact of patient characteristics and lifestyle on the subjective achievement of these outcomes was evaluated to set the answers in context and show its influence. Statistical analysis was performed using SPSS Statistics for Windows version 26 (IBM Corporation, Armonk in New York, USA). Mean, standard deviation, minimum, and maximum were calculated for age and BMI. The other characteristics regarding demographics, lifestyle, tumor disease, and therapy were analyzed based on their respective absolute and relative frequencies.
RESULTS
A large majority of the patients' participation goal was to reduce cancer-related side effects (90.8%), second were the aspects of "Improvement of the disease-related quality of life "(72.5%). In both cases, this common goal was only fully achieved for about one quarter of the patients (25.7%/24.1%), but partially achieved in more than half of the asked patients (53.2%/52.9%). Half of the patients reported that they achieved active participation in cancer treatment with integrative medicine. Around 50% partially achieved stabilization of the body, soul, and spirit, stress, disease management, improvement in cancer-related quality of life, and reduced the side effects of conventional cancer therapies. The success of integrative therapy was independent of age, BMI, family status, children, level of education, insurance type, alcohol and tobacco consumption, sport, low-fat diet, daily fruit and vegetable servings, interest in diets, and previous use of diets.
CONCLUSIONS AND DISCUSSION
Using a standardized procedure in integrative medicine allows patients to receive high-quality care. The previous standard of living has no effect on the benefits of integrative medicine for the patient. The goals through the use of integrative medicine could be achieved by all patient groups. It is highly encouraged to incorporate counseling and evidence-based integrative medicine into the clinical routines of cancer centers and adapt postgraduate medical education. Finally, the evidence base for the recommendations should also be strengthened by further research into the use of integrative medicine.
背景
由于癌症诊断和治疗技术的进步,癌症患者的预后有了显著改善。生存期显著延长带来的益处使得人们更加关注生活质量以及肿瘤治疗期间的副作用管理。已发现实施整合医学策略可减少治疗和疾病的副作用。2021年,德国首次发布了肿瘤学补充医学S3指南,该指南对德国补充与整合医学的最常见方面表明了立场。目的是了解先前的健康生活方式是否会影响整合医学对患者的治疗效果。
方法
在一项为期15个月的横断面研究框架内,在埃尔朗根大学医院妇产科大学整合医学中心的标准化整合医学咨询服务处对120名癌症患者进行了监测。基本问卷包括关于社会经济背景信息、生活方式因素(如饮食习惯或吸烟行为)以及妇科情况的问题。此外,基于患者报告的治疗目标进行评估,这些目标包括减少传统癌症治疗的副作用、提高疾病相关生活质量、更好地管理压力和疾病、积极参与癌症治疗、身心稳定以及改善应对策略。此外,评估了患者特征和生活方式对这些结果主观达成情况的影响,以便将答案置于背景中并显示其影响。使用SPSS Statistics for Windows 26版(美国纽约州阿蒙克市IBM公司)进行统计分析。计算了年龄和体重指数的均值、标准差、最小值和最大值。根据各自的绝对和相对频率分析了人口统计学、生活方式、肿瘤疾病和治疗的其他特征。
结果
绝大多数患者的参与目标是减少癌症相关副作用(90.8%),其次是“改善疾病相关生活质量”方面(72.5%)。在这两种情况下,这一共同目标仅在约四分之一的患者中完全实现(25.7%/24.1%),但在超过一半的受访患者中部分实现(53.2%/52.9%)。一半的患者报告称他们通过整合医学实现了积极参与癌症治疗。约50%的患者部分实现了身心稳定、压力和疾病管理、癌症相关生活质量改善以及传统癌症治疗副作用减少。整合治疗的成功与年龄、体重指数、家庭状况、子女、教育程度、保险类型、饮酒和吸烟、运动、低脂饮食、每日水果和蔬菜摄入量、对饮食的兴趣以及先前的饮食使用情况无关。
结论与讨论
在整合医学中使用标准化程序可使患者获得高质量护理。先前的生活水平对整合医学对患者的益处没有影响。所有患者群体都可以通过使用整合医学实现目标。强烈鼓励将咨询和循证整合医学纳入癌症中心的临床常规,并调整毕业后医学教育。最后,还应通过对整合医学使用的进一步研究来加强建议的证据基础。