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The benefits of psychosocial interventions for cancer patients undergoing radiotherapy.

Guo Z, Tang HY, Li H, Tan SK, Feng KH, Huang YC, Bu Q, Jiang W - Health Qual Life Outcomes (2013)

Bottom Line: Patients randomly assigned to the intervention arm showed significant improvements on symptoms of depression (p < 0.05) and anxiety (p < 0.05), health-related QOL (p < 0.05) (i.e. better global health status, and physical and emotional functioning, and less insomnia) when compared with controls.However, the intervention was not found to reduce the risk of cancer recurrence and death.ChiCTR-TRC-12002438.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Guilin Medical College Affiliated Hospital, 15 Lequn Road, Guilin, People's Republic of China.

ABSTRACT

Background: Many patients with cancer experience depression and anxiety, and an associated decrease in quality of life (QOL) during radiation therapy (RT). The main objective of the study was to determine the benefits of psychosocial interventions for cancer patients who received RT.

Methods: Patients with cancer (n = 178) who agreed to participate in the study were randomized to the intervention arm (n = 89) or the control arm (n = 89). Patients in the intervention group received psychosocial care during RT, whereas the control group received RT only. The benefits of the intervention were evaluated using the Zung Self-rating Depression Scale (SDS) to measure depression, the Self-rating Anxiety Scale (SAS) to assess anxiety, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) to survey health-related QOL. The association between intervention and survival was also assessed.

Results: Patients randomly assigned to the intervention arm showed significant improvements on symptoms of depression (p < 0.05) and anxiety (p < 0.05), health-related QOL (p < 0.05) (i.e. better global health status, and physical and emotional functioning, and less insomnia) when compared with controls. In the subset analysis, female patients, those that received high dose irradiation, and those that underwent adjuvant chemotherapy could benefit more from psychosocial intervention. There was no difference between the two groups in disease-free survival (DFS) (2-year DFS 79.8% in the intervention arm and 76.4% in the control arm; p = 0.527) and overall survival (OS) (2-year OS 83.1% in the intervention arm and 84.3% in the control arm; p = 0.925) CONCLUSIONS: Psychosocial intervention is a cost-effective approach that can improve a patient's mood and QOL both during and after RT. However, the intervention was not found to reduce the risk of cancer recurrence and death.

Trial registration: ChiCTR-TRC-12002438.

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Related in: MedlinePlus

Survival analysis in patients randomly assigned to intervention group or control group. Kaplan–Meier survival curve for the overall survival in all patients (A), nasopharyngeal carcinoma (C), breast cancer (E) and gynecological cancer (G). Kaplan–Meier survival curve for the time to progression in all patients (B), nasopharyngeal carcinoma (D), breast cancer (F) and gynecological cancer (H).
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Figure 2: Survival analysis in patients randomly assigned to intervention group or control group. Kaplan–Meier survival curve for the overall survival in all patients (A), nasopharyngeal carcinoma (C), breast cancer (E) and gynecological cancer (G). Kaplan–Meier survival curve for the time to progression in all patients (B), nasopharyngeal carcinoma (D), breast cancer (F) and gynecological cancer (H).

Mentions: The main OS and DFS analysis included the 178 patients. A total of 29 patients (16%) died – 15 (17%) in the intervention arm and 16 (18%) in the control arm; 10 patients (6%) were lost to follow-up – 4 (4%) in the intervention arm and 6 (7%) in the control arm. Disease-free survival rates at 2 years were 79.8% for the intervention arm and 76.4% for the control arm (two-sided log-rank, p = 0.527; Figure 2A). The 2-year overall survival rates were 83.1% for the intervention arm and 84.3% for the control arm (two-sided log-rank, p = 0.925; Figure 2B). At 2 years follow-up, there was no improvement in DFS and OS rate in the intervention arm compared with the control arm.


The benefits of psychosocial interventions for cancer patients undergoing radiotherapy.

Guo Z, Tang HY, Li H, Tan SK, Feng KH, Huang YC, Bu Q, Jiang W - Health Qual Life Outcomes (2013)

Survival analysis in patients randomly assigned to intervention group or control group. Kaplan–Meier survival curve for the overall survival in all patients (A), nasopharyngeal carcinoma (C), breast cancer (E) and gynecological cancer (G). Kaplan–Meier survival curve for the time to progression in all patients (B), nasopharyngeal carcinoma (D), breast cancer (F) and gynecological cancer (H).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3721996&req=5

Figure 2: Survival analysis in patients randomly assigned to intervention group or control group. Kaplan–Meier survival curve for the overall survival in all patients (A), nasopharyngeal carcinoma (C), breast cancer (E) and gynecological cancer (G). Kaplan–Meier survival curve for the time to progression in all patients (B), nasopharyngeal carcinoma (D), breast cancer (F) and gynecological cancer (H).
Mentions: The main OS and DFS analysis included the 178 patients. A total of 29 patients (16%) died – 15 (17%) in the intervention arm and 16 (18%) in the control arm; 10 patients (6%) were lost to follow-up – 4 (4%) in the intervention arm and 6 (7%) in the control arm. Disease-free survival rates at 2 years were 79.8% for the intervention arm and 76.4% for the control arm (two-sided log-rank, p = 0.527; Figure 2A). The 2-year overall survival rates were 83.1% for the intervention arm and 84.3% for the control arm (two-sided log-rank, p = 0.925; Figure 2B). At 2 years follow-up, there was no improvement in DFS and OS rate in the intervention arm compared with the control arm.

Bottom Line: Patients randomly assigned to the intervention arm showed significant improvements on symptoms of depression (p < 0.05) and anxiety (p < 0.05), health-related QOL (p < 0.05) (i.e. better global health status, and physical and emotional functioning, and less insomnia) when compared with controls.However, the intervention was not found to reduce the risk of cancer recurrence and death.ChiCTR-TRC-12002438.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Guilin Medical College Affiliated Hospital, 15 Lequn Road, Guilin, People's Republic of China.

ABSTRACT

Background: Many patients with cancer experience depression and anxiety, and an associated decrease in quality of life (QOL) during radiation therapy (RT). The main objective of the study was to determine the benefits of psychosocial interventions for cancer patients who received RT.

Methods: Patients with cancer (n = 178) who agreed to participate in the study were randomized to the intervention arm (n = 89) or the control arm (n = 89). Patients in the intervention group received psychosocial care during RT, whereas the control group received RT only. The benefits of the intervention were evaluated using the Zung Self-rating Depression Scale (SDS) to measure depression, the Self-rating Anxiety Scale (SAS) to assess anxiety, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) to survey health-related QOL. The association between intervention and survival was also assessed.

Results: Patients randomly assigned to the intervention arm showed significant improvements on symptoms of depression (p < 0.05) and anxiety (p < 0.05), health-related QOL (p < 0.05) (i.e. better global health status, and physical and emotional functioning, and less insomnia) when compared with controls. In the subset analysis, female patients, those that received high dose irradiation, and those that underwent adjuvant chemotherapy could benefit more from psychosocial intervention. There was no difference between the two groups in disease-free survival (DFS) (2-year DFS 79.8% in the intervention arm and 76.4% in the control arm; p = 0.527) and overall survival (OS) (2-year OS 83.1% in the intervention arm and 84.3% in the control arm; p = 0.925) CONCLUSIONS: Psychosocial intervention is a cost-effective approach that can improve a patient's mood and QOL both during and after RT. However, the intervention was not found to reduce the risk of cancer recurrence and death.

Trial registration: ChiCTR-TRC-12002438.

Show MeSH
Related in: MedlinePlus