Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients

被引:58
作者
Dean-Clower, Elizabeth [5 ]
Doherty-Gilman, Anne M.
Keshaviah, Aparna [4 ]
Baker, Frank [2 ]
Kaw, Chiewkwei [3 ]
Lu, Weidong [5 ]
Manola, Judith
Penson, Richard T. [4 ,5 ]
Matulonis, Ursula A. [5 ]
Rosenthal, David S. [1 ,5 ]
机构
[1] Dana Farber Canc Inst, Leonard P Zakim Ctr Integrat Therapies, Boston, MA 02115 USA
[2] New York Med Coll, Ctr Med Outcomes Res, Sch Hlth Sci & Practice, Valhalla, NY 10595 USA
[3] Amer Canc Soc, Atlanta, GA 30329 USA
[4] Massachusetts Gen Hosp, Boston, MA 02114 USA
[5] Harvard Univ, Sch Med, Boston, MA USA
关键词
acupuncture; palliative care; symptom management; ovarian cancer; breast cancer; ALTERNATIVE MEDICINE USE; BREAST-CANCER; SHORT-FORM; COMPLEMENTARY; PAIN; ELECTROACUPUNCTURE; PREVALENCE; ATTITUDES; SURVIVORS; PROFILE;
D O I
10.1177/1534735409360666
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL). Methods. This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session. A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points. Results. Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain, and depression and significant improvement over time for patients with anxiety (P=.001) and depression (P=.02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P=.001), fatigue (P=.0002), pain (P=.0002), and depression (P=.003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks. Conclusions. This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.
引用
收藏
页码:158 / 167
页数:10
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