Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial.
Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial.
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DOI：
10.1002/cncr.23969
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发表时间：
2008-12-15
期刊：
影响因子：
6.2
通讯作者：
Carson, William E., III
中科院分区：
文献类型：
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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
压力是否会造成癌症进展的风险这个问题一直很难回答。一项随机临床试验测试了一种假设，即癌症患者接受了最近的诊断，但接受了心理干预，与只接受评估的患者相比，他们的存活率会提高。共有227名因区域乳腺癌而接受手术治疗的患者参加了研究。在开始癌症辅助治疗之前，患者接受心理和行为测量评估，并进行健康评估，并抽取60毫升血样。患者被随机分为心理干预加评估或仅评估研究组。干预是由心理学家引导的；以小组形式进行；包括减轻压力、改善情绪、改变健康行为以及保持对癌症治疗和护理的坚持。早些时候的文章表明，与评估组相比，干预组在所有后者的次要结果中都有所改善。免疫力也得到了增强。经过中位数11年的随访，212名妇女中有62名(29%)报告了疾病复发，227名妇女中有54名(24%)死亡。采用COX比例风险分析进行多因素生存比较。正如预测的那样，与仅评估组的患者相比，干预组患者的乳腺癌复发风险(风险比[HR]为0.55；P=.034)和乳腺癌死亡率(HR=0.44；P=.016)被发现降低。随访分析还表明，干预患者的全死因死亡风险降低(HR为0.51；P=.028)。在这里提供和研究的心理干预可以提高存活率。
The question of whether stress poses a risk for cancer progression has been difficult to answer. A randomized clinical trial tested the hypothesis that cancer patients coping with their recent diagnosis but receiving a psychologic intervention would have improved survival compared with patients who were only assessed. A total of 227 patients who were surgically treated for regional breast cancer participated. Before beginning adjuvant cancer therapies, patients were assessed with psychologic and behavioral measures and had a health evaluation, and a 60-mL blood sample was drawn. Patients were randomized to Psychologic Intervention plus assessment or Assessment only study arms. The intervention was psychologist led; conducted in small groups; and included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Earlier articles demonstrated that, compared with the Assessment arm, the Intervention arm improved across all of the latter secondary outcomes. Immunity was also enhanced. After a median of 11 years of follow-up, disease recurrence was reported to occur in 62 of 212 (29%) women and death was reported for 54 of 227 (24%) women. Using Cox proportional hazards analysis, multivariate comparison of survival was conducted. As predicted, patients in the Intervention arm were found to have a reduced risk of breast cancer recurrence (hazards ratio [HR] of 0.55; P=.034) and death from breast cancer (HR of 0.44; P=.016) compared with patients in the Assessment only arm. Follow-up analyses also demonstrated that Intervention patients had a reduced risk of death from all causes (HR of 0.51; P=.028). Psychologic interventions as delivered and studied here can improve survival.
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影响因子：
11.2
作者：
Bunt, Stephanie K.;Yang, Linglin;Ostrand-Rosenberg, Suzanne
通讯作者：
Ostrand-Rosenberg, Suzanne
影响因子：
15.1
作者：
Andersen, Barbara L.;Farrar, William B.;Carson, William E., III
通讯作者：
Carson, William E., III
影响因子：
2.8
作者：
Kohout, F J;Berkman, L F;Cornoni-Huntley, J
通讯作者：
Cornoni-Huntley, J
影响因子：
15.1
作者：
BENELIYAHU, S;YIRMIYA, R;GALE, RP
通讯作者：
GALE, RP
DOI：
10.1111/j.1749-6632.2002.tb04229.x
发表时间：
2002-01-01
期刊：
NEUROENDOCRINE IMMUNE BASIS OF THE RHEUMATIC DISEASES II, PROCEEDINGS
影响因子：
--
作者：
Elenkov, IJ;Chrousos, GP
通讯作者：
Chrousos, GP