title: Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach.
abstract: 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 two different indicators of depressed mood (CES-D 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.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, IA 52242, USA. susan-lutgendorf@uiowa.edu
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mullen-Houser
authors.forename: Daniel
authors.initials: D
authors.lastname: Russell
authors.forename: Koen
authors.initials: K
authors.lastname: Degeest
authors.forename: Geraldine
authors.initials: G
authors.lastname: Jacobson
authors.forename: Laura
authors.initials: L
authors.lastname: Hart
authors.forename: David
authors.initials: D
authors.lastname: Bender
authors.forename: Barrie
authors.initials: B
authors.lastname: Anderson
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Buekers
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goodheart
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: David M
authors.initials: DM
authors.lastname: Lubaroff
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003131:Combined Modality Therapy; D000529:Complementary Therapies; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000502:physiology; D007958:Leukocyte Count; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D012063:Relaxation / Q000502:physiology; D012064:Relaxation Therapy; D012944:Social Support; D012959:Socioeconomic Factors; D019124:Therapeutic Touch; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents