Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach.
Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach.
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DOI：
10.1016/j.bbi.2010.06.014
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发表时间：
2010-11
影响因子：
15.1
通讯作者：
Lubaroff, David M.
中科院分区：
文献类型：
--
作者：
Lutgendorf, Susan K.;Mullen-Houser, Elizabeth;Russell, Daniel;DeGeest, Koen;Jacobson, Geraldine;Hart, Laura;Bender, David;Anderson, Barrie;Buekers, Thomas E.;Goodheart, Michael J.;Antoni, Michael H.;Sood, Anil K.;Lubaroff, David M.
关键词：
接受宫颈癌放化疗的患者有痛苦、放化疗相关副作用和免疫抑制的风险。这项前瞻性随机临床试验检查了补充疗法愈合触摸（HT）与放松训练（RT）和常规护理（UC）在接受放化疗的宫颈癌患者中的作用：1）支持细胞免疫，2）改善情绪和生活质量（QOL），3）减少治疗相关毒性和治疗延迟。将60名IB1至IVA期宫颈癌患者随机分配至接受UC或每周4次的HT或RT治疗，在6周的放化疗治疗期间，放疗后立即进行。在基线、第4周和第6周，患者在放化疗前完成心理社会评估和血液采样。使用正交对比进行多水平回归分析，检测治疗条件随时间的差异。HT患者在治疗过程中自然杀伤细胞毒性（NKCC）的降低最小，而RT和UC患者的NKCC在放化疗期间急剧下降（组与时间相互作用：p=0.018）。与RT和UC相比，HT患者在抑郁情绪的2个不同指标（CESD抑郁情绪子量表和POMS抑郁量表）中表现出更大的下降（组与时间的相互作用：p < 0.05）。在QOL、治疗延迟或临床评定毒性方面未观察到组间差异。HT可能通过调节放化疗对抑郁情绪和细胞免疫的影响而使宫颈癌患者受益。未观察到HT对毒性、治疗延迟、生活质量和疲劳的影响。研究结果的长期临床意义尚不清楚。
Patients receiving chemoradiation for cervical cancer are at risk for distress, chemoradiation-related side-effects, and immunosuppression. This prospective randomized clinical trial examined effects of a complementary therapy, Healing Touch (HT), versus relaxation training (RT) and usual care (UC) for 1) supporting cellular immunity, 2) improving mood and quality of life (QOL), and 3) reducing treatment-associated toxicities and treatment delay in cervical cancer patients receiving chemoradiation. Sixty women with stages IB1 to IVA cervical cancer were randomly assigned to receive UC or 4×/weekly individual sessions of either HT or RT immediately following radiation during their 6-week chemoradiation treatment. Patients completed psychosocial assessments and blood sampling before chemoradiation at baseline, weeks 4 and 6. Multilevel regression analyses using orthogonal contrasts tested for differences between treatment conditions over time. HT patients had a minimal decrease in natural killer cell cytotoxicity (NKCC) over the course of treatment whereas NKCC of RT and UC patients declined sharply during chemoradiation (group by time interaction: p=0.018). HT patients showed greater decreases in 2 different indicators of depressed mood (CESD depressed mood subscale and POMS depression scale) compared to RT and UC (group by time interactions: p < 0.05). No between group differences were observed in QOL, treatment delay, or clinically-rated toxicities. HT may benefit cervical cancer patients by moderating effects of chemoradiation on depressed mood and cellular immunity. Effects of HT on toxicities, treatment delay, QOL, and fatigue were not observed. Long-term clinical implications of findings are not known.
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影响因子：
7.4
作者：
Beano, Alessandra;Signorino, Elena;Matera, Lina
通讯作者：
Matera, Lina
影响因子：
4.7
作者：
Hann, D;Winter, K;Jacobsen, P
通讯作者：
Jacobsen, P
影响因子：
3.8
作者：
Arreygue-Garcia NA;Daneri-Navarro A;del Toro-Arreola A;Cid-Arregui A;Gonzalez-Ramella O;Jave-Suarez LF;Aguilar-Lemarroy A;Troyo-Sanroman R;Bravo-Cuellar A;Delgado-Rizo V;Garcia-Iglesias T;Hernandez-Flores G;Del Toro-Arreola S
通讯作者：
Del Toro-Arreola S
影响因子：
6.2
作者：
Andersen, Barbara L.;Yang, Hae-Chung;Farrar, William B.;Golden-Kreutz, Deanna M.;Emery, Charles F.;Thornton, Lisa M.;Young, Donn C.;Carson, William E., III
通讯作者：
Carson, William E., III
影响因子：
4.7
作者：
Antoni, Michael H.;Pereira, Deidre B.;O'Sullivan, Mary Jo
通讯作者：
O'Sullivan, Mary Jo